Prevalence and Pattern of Diabetic Retinopathy Among Diabetic Patients With Chronic Kidney Disease Attending the Renal Outpatient Clinic in Kenyatta National Hospital
Abstract
Study Background
Over the last several decades, there has been a global increase in the prevalence of diabetes
mellitus. As the number of people living with diabetes is increasing, so is the number of people
suffering from the complications of uncontrolled diabetes, which include macro-angiopathies
and micro-angiopathies such as nephropathy, retinopathy and neuropathy. Whereas
retinopathy is almost universal in patients with DM, only about 40% of diabetic patients have
chronic kidney disease (CKD).
Study Objective
This study sought to determine the prevalence and pattern of diabetic retinopathy among
patients with chronic renal disease attending the Kenyatta National Hospital renal outpatient
clinic.
Materials and methods
This was a cross-sectional hospital-based study carried out among adult patients with
diabetes and chronic kidney disease at the renal outpatient clinic. It was conducted between
March and April 2023. Each participant gave informed consent, and a pre-designed data
collection tool was filled. We recruited 102 participants; 47 were females, and 55 were male
(F:M 1:1.2). The participants underwent a single-shot macula-centered non-mydriatic retina
photo of each eye. The photos were graded using the ETDRS score for DR in their original
form. The worse eye was taken as the diagnosis of the participant. The data was analysed
using SPSS Version 26 in descriptive and inferential statistics and presented in tables and
figures.
Results
The prevalence of DR among known DM-CKD patients at KNH ROPC was 56.7% (95 % CI,
49.7%-62.4%). DR was more prevalent among participants who had DM for more than ten
years and HBA1c of more than 6%. Among the study participants, we found that mild NPDR
was 22%, moderate NPDR 8%, severe NPDR 9% and PDR 18%. We did not find a statistically
significant association between increasing severity of CKD and worsening ETDRS DR stage.
Only 21.6% of diabetic patients with CKD at ROPC had undergone a retina exam within one
year preceding the study.
Recommendations
There is a need to increase screening of diabetic patients at the ROPC
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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