Journal List > J Korean Ophthalmol Soc > v.57(10) > 1010427

TOOLS
Kim, Jin, Chang, Hwang, and Lee: The Effect of Fluorescein Angiography on Renal Function in Patients with Diabetic Retinopathy
Original Article

J Korean Ophthalmol Soc 2016;57(10):1598-1603.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1598

The Effect of Fluorescein Angiography on Renal Function in Patients with Diabetic Retinopathy

Jung Tae Kim, MD1, Sun Young Jin, MD1, Young Suk Chang, MD1, Won Min Hwang, MD2, Young Hoon Lee, MD1

1Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea

2Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea

Address reprint requests to Young Hoon Lee, MD Department of Ophthalmology, Konyang University Hospital, #158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: 82-42-600-9258, Fax: 82-42-600-9251 E-mail: Astrix001@gmail.com

Received 30 December 2015       Accepted 5 October 2016

Copyright © 2016 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was designed to compare the change of renal function before and after fluorescein angiography in patients with diabetic retinopathy.

Methods

This study included 80 patients diagnosed with diabetic retinopathy who did not receive dialysis from April 2004 to December 2014. Based on retrospective analysis of a blood test performed within one week before and after fluorescein angiography, the changes of blood urea nitrogen (BUN), serum creatinine (Scr), and estimated glomerular filtration rate (eGFR) were measured. Additionally, the effect of fluorescein angiography on renal function was estimated according to chronic kidney disease (CKD) stage.

Results

The average BUN/SCr before and after fluorescein angiography was not statistically significantly different before and after fluorescein angiography. The average eGFR before and after fluorescein angiography increased from 62.62 ± 31.59 to 66.46 ± 31.22 (p = 0.006). Regarding changes in renal functions according to CKD stage, based on the average eGFR in CKD stages 5, 4, 2, and 1, no significant differences were observed in renal functions before and after fluorescein angiography, whereas eGFR was significantly increased after fluorescein angiography at CKD stage 3 (p = 0.042).

Conclusions

In patients with diabetic retinopathy, BUN/Scr and eGFR were not significantly different before or after fluorescein angiography. Moreover, the deterioration of renal function was not observed at any CKD stage. Therefore, fluorescein angiography is a relatively safe diagnostic examination in patients with diabetic retinopathy who did not receive dialysis due to the low-risk of renal function deterioration.

Keywords: Fluorescein angiography, Renal function

References

1. Novotny HR, Alvis DL. A method of photographing fluorescence in circulating blood in the human retina. Circulation. 1961; 24:82–6.
crossref
2. Yannuzzi LA, Rohrer KT, Tindel LJ, et al. Fluorescein abdominal complication survey. Ophthalmology. 1986; 93:611–7.
3. Das A, McGuire PG, Rangasamy S. Diabetic macular edema: pathophysiology and novel therapeutic targets. Ophthalmology. 2015; 122:1375–94.
crossref
4. Cheng JY, Yap EY, Chao AK, Au Eong KG. Extensive upper-ex-tremity venous thrombosis after fluorescein angiography. Am J Ophthalmol. 2005; 139:928–30.
crossref
5. Kameda Y, Babazono T, Haruyama K, et al. Renal function abdominal fluorescein angiography in diabetic patients with chronic kidney disease. Diabetes Care. 2009; 32:e31.
6. Alemzadeh-Ansari MJ, Beladi-Mousavi SS, Feghhei M. Effect of fluorescein on renal function among diabetic patients. Nefrologia. 2011; 31:612–3.

Table 1.
Characteristics of patients
  Subject No. (N = 80)
Mean ages (years) 56.6 ± 11.5
Sex  
   Male 44
   Female 36
HTN  
   Yes 40
   No 40
Kidney disease  
   Yes 21
   No 59
Use of NSAID  
   Yes 1
   No 79
Hydration  
   Yes 29
   No 51
CKD stage  
   Stage 1 19
   Stage 2 23
   Stage 3 19
   Stage 4 15
   Stage 5 4

Values are presented as mean ± SD unless otherwise indicated. SD = standard deviation; HTN = hypertension; NSAID = nonsteroidal anti-inflammatory drugs; CKD = chronic kidney disease.

Table 2.
Comparison of changes in eGFR between before and after FAG following clinical features of the patients
    eGFR difference p-value*
Sex Male (N = 44) 1.30 ± 10.98 0.210
  Female (N = 36) 6.95 ± 12.68  
HTN Yes (N = 40) 4.23 ± 11.88 0.761
  No (N = 40) 3.44 ± 12.33  
Kidney disease Yes (N = 21) 3.24 ± 6.28 0.005
  No (N = 59) 4.05 ± 13.55  
Hydration Yes (N = 29) 6.82 ± 15.50 0.006
  No (N = 51) 2.15 ± 9.29  

Values are presented as mean ± SD unless otherwise indicated.

eGFR = estimated glomerular filtration rate; FAG = fluorescein angiography; HTN = hypertension.

* Independent-samples t-test.

Table 3.
The change of BUN/Cr and eGFR between before and after FAG
  Before FAG After FAG p-value*
BUN 22.70 ± 12.90 20.95 ± 11.25 0.045
Cr 1.74 ± 2.65 1.41 ± 0.99 0.227
eGFR 62.62 ± 31.59 66.46 ± 31.22 0.006

Values are presented as mean ± SD unless otherwise indicated.

BUN = blood urea nitrogen; Cr = creatinine; eGFR = estimated glomerular filtration rate; FAG = fluorescein angiography.

* Paired t-test.

Table 4.
The change of BUN/Cr and eGFR between before and after FAG according to CKD stage
  Before FAG After FAG p-value*
CKD stage 1 (90 ≤ eGFR) (N = 19)      
   BUN 13.04 ± 4.92 14.80 ± 6.63 0.121
   Cr 0.74 ± 0.17 0.77 ± 0.18 0.129
   eGFR 105.35 ± 12.61 103.22 ± 13.91 0.155
CKD stage 2 (60 ≤ eGFR < 89) (N = 23)      
   BUN 18.24 ± 6.26 16.03 ± 4.43 0.187
   Cr 1.01 ± 0.19 0.97 ± 0.26 0.284
   eGFR 72.79 ± 7.08 78.29 ± 14.72 0.085
CKD stage 3 (30 ≤ eGFR < 59) (N = 19)      
   BUN 24.27 ± 10.06 21.52 ± 9.45 0.028
   Cr 1.41 ± 0.31 1.33 ± 0.39 0.095
   eGFR 48.81 ± 8.09 54.79 ± 14.38 0.041
CKD stage 4 (15 ≤ eGFR < 29) (N = 15)      
   BUN 35.57 ± 15.66 30.92 ± 13.09 0.152
   Cr 3.77 ± 5.48 2.14 ± 0.74 0.270
   eGFR 23.98 ± 3.69 31.19 ± 13.88 0.053
CKD stage 5 (eGFR < 15) (N = 4)      
   BUN 36.60 ± 16.62 38.77 ± 15.20 0.898
   Cr 4.65 ± 1.13 4.69 ± 0.86 0.854
   eGFR 11.55 ± 2.00 11.37 ± 2.64 0.829

Values are presented as mean ± SD unless otherwise indicated.

BUN = blood urea nitrogen; Cr = creatinine; eGFR = estimated glomerular filtration rate; FAG = fluorescein angiography; CKD = chronic kidney disease.

* Paired t-test.

TOOLS
Similar articles