Chronic Kidney Disease Severity and Progression to Proliferative Diabetic Retinopathy
Authors' conclusion
CKD Stage 3 or higher was associated with greater progression from NPDR to PDR and severe retinal complications.
Study context
- Population
- Adults with T2D and nonproliferative diabetic retinopathy (NPDR); prior proliferative diabetic retinopathy (PDR), diabetic macular oedema, intravitreal treatment or vitrectomy excludedmatched cohorts
- Exposure
- Chronic kidney disease (CKD) vs no CKD
- CKD Stages 1-2n = 8,476
- CKD Stage 3n = 24,432
- CKD Stages 4-5n = 9,933
- ESRDn = 7,359
- Outcome
- PDR
- Follow-up
- 3 years
Methodological detailsTriNetX, matched 1:1 by CKD stage
- TriNetX
- Matched 1:1 by CKD stage
Main finding
As reported in the abstract
Each group vs no CKDHazard ratio (95% CI)
CKD Stages 1-2
1.12(0.96–1.29)
CKD Stage 3
1.35(1.23–1.47)
CKD Stages 4-5
1.59(1.40–1.80)
ESRD
1.66(1.45–1.89)
Observational data: associations, not effects.
Further findings
Composite of PDR, vitreous haemorrhage, tractional retinal detachment or vitrectomy · 3 years
- Similar associations were observed for the composite
Sensitivity analyses (laboratory-defined eGFR; mild-NPDR-restricted)
- Associations persisted in laboratory-defined and mild-NPDR-restricted analyses, although residual baseline HbA1c imbalance remained in advanced CKD comparisons
Original publication
Chronic Kidney Disease Severity and Progression to Proliferative Diabetic Retinopathy. Diabetes Obes Metab. Published 17 September 2026. doi:10.
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