The Relationship of Renal Function With Carotid Atherosclerosis According to Retinopathy Presence in Patients With Tip 2 Diabetes Mellitus

Introduction: Patients with diabetes having diabetic retinopathy (DR) or nephropathy may predict future risk of coronary artery disease. To predict cardiovascular outcomes carotid intima-media thickness (CIMT) is utilized in diabetic patients. Objectives: The aim of our study was the evaluation of the relationship between severity of renal dysfunction and CIMT according to presence of retinopathy as all of them are non-invasive methods for early detection of micro- and macrovascular complications of diabetes. Methods: This comparative cross-sectional study was conducted in our hospital from September 2022 to January 2023. Ninety three patients with type 2 diabetes mellitus were enrolled in the study. Ophthalmological examination was done to screen patients for DR. CIMT was evaluated by a Doppler ultrasound for both carotid arteries and the most distorted area between both carotid arteries was considered. Based on the estimated glomerular filtration rate (eGFR), they were divided into two groups. The effect of kidney status on carotid atherosclerosis due to the presence of diabetic retinopathy was analyzed. Results: Ninety-three patients with type 2 diabetes were included in this study. 47% of the patients included in the study were male, 50% had hypertension and 30% had hyperlipidemia. Carotid artery intimal thickness was more in patients with decreased kidney function compared to patients with better kidney function (p > 0.05). No association was observed between CIMT and DR. Renal dysfunction was associated with carotid atherosclerosis in univariate and multivariate analysis [OR .4.4 (1.7-11.4), p = 0.002 and OR 4.7 (1.4-15.7), p = 0.01]. Conclusion: Our results showed that the deterioration of renal function seems to be parallel to the severity of carotid atherosclerosis independent of retinopathy, hypertension and dyslipidemia presence in patients with diabetes mellitus.