[The correlation between inflammatory factors and renal function impairment in patients with proliferative diabetic retinopathy undergoing vitrectomy].

Abstract

Objective: To investigate the correlation between inflammatory factors and renal function impairment in patients with proliferative diabetic retinopathy (PDR) undergoing pars plana vitrectomy. Methods: The clinical data of patients with PDR who underwent vitreoretinal surgery at Beijing Tongren Hospital, Capital Medical University, from July 2019 to January 2021 were retrospectively analyzed. Using a estimated glomerular filtration rate (eGFR) cut-off value of<60 ml·min^-1· (1.73 m²)^-1, the cohort was stratified into two groups: renal impairment group and non-renal impairment group. The differences between the two groups were compared, and a multivariate logistic regression model was used to examine the factors associated with renal function injury. Results: A total of 923 patients aged (51.5±11.6) years were enrolled in the study, including 537 males and 386 females. There were 151 patients (16.4%) and 772 patients (83.6%) in renal impairment group and non-renal impairment group, respectively. Compared with the non-renal impairment group, the renal impairment group had higher systolic blood pressure (SBP), neutrophil count, high-sensitivity C-reactive protein (hs-CRP), homocysteine, triglycerides, total cholesterol, and complement C4 levels (all P<0.05). However, glycated hemoglobin (HbA1c), lymphocyte count, serum albumin, high-density lipoprotein cholesterol (HDL-C), and complement C3 levels were lower in the renal impairment group (all P<0.05). Multivariate logistic regression analysis demonstrated that elevated hs-CRP (OR=1.041, 95%CI: 1.002-1.082), reduced complement C3 (OR=0.996, 95%CI: 0.995-0.998), and elevated complement C4 (OR=1.007, 95%CI: 1.005-1.010) were inflammatory-related factors associated with renal impairment in patients with PDR. Other related factors included SBP (OR=1.015, 95%CI: 1.002-1.028), serum albumin (OR=0.842, 95%CI: 0.806-0.879), and homocysteine (OR=1.098, 95%CI: 1.064-1.132). Conclusion: There is a correlation between inflammatory factors (such as hs-CRP, complement C3, and complement C4) and the occurrence of renal function impairment in PDR patients undergoing vitrectomy.