HUBUNGAN DIAMETER VASKULAR RETINA DENGAN ESTIMASI LAJU FILTRASI GLOMERULUS PADA PENDERITA DIABETES MELLITUS TIPE 2
YULIA WARDANY, dr. Angela Nurini Agni, M.Kes., Sp.M(K); dr. Hartono,SpM(K)
2015 | Tesis | SP ILMU PENYAKIT MATATujuan : Untuk mengetahui apakah terdapat hubungan antara diameter vaskular retina dengan estimasi laju filtrasi glomerulus pada penderita diabetes tipe 2. Metode : Desain penelitian berupa potong lintang. Subjek diambil dari penelitian besar “Jogjakarta Eye Diabetic Study in the Community (JOGED.COM) terdiri dari 75 pasien DM tipe 2 berumur ≥ 30 tahun.. Variable bebas adalah diameter vaskular retina dan variable terikat adalah eGFR. Diameter vaskular retina diukur dengan software SIVA dan hasilnya dalam bentuk ekuivalent CRAE dan CRVE. CRAE dengan diameter <150mikron-m dimasukkan sebagai variable CRAE kecil sedangkan diameter >168 mikron-m dimasukkan sebagai variable CRAE besar. CKD stadium 3 didefenisikan sebagai eGFR <60 mL/min per 1.73 m2. Data pengukuran dianalisa dengan SSPS 21. Hasil : Terdapat korelasi positif antara CRAE dengan eGFR (r=0,331, p=0,007). Tidak ditemukan korelasi antara CRVE dengan GFR (r=0,020, p=0,086). Rerata CRAE pada kelompok CKD stadium 3 lebih kecil(n= 35, p=0,001) dibandingkan pada kelompok non-CKD(n=40), dan setelah mengontrol faktor umur, tekanan darah sistolik dan diastolik, hipertensi, IMT, durasi DM, didapatkan Odds rasio 7,064 antara kelompok CRAE kecil dibandingkan kelompok CRAE besar(CI 1,394-32,795, p=0,005). Kesimpulan : Terdapat korelasi lemah antara CRAE dengan eGFR, tidak terdapat korelasi antara CRVE dengan eGFR. Diameter arteriola yang kecil mempunyai risiko CKD stadium 3 sebanyak 7 kali lebih besar dibandingkan diameter arteriola retina besar.
Objective : To determine whether there is a correlation between retinal vascular diameter with an estimated glomerular filtration rate in patients with type 2 diabetes. Metode : a cross sectional study. Subjects were taken from "Diabetic Eye Study Jogjakarta in the Community consisting of 75 patients with type 2 diabetes (≥30years old). Independent variable was retinal vascular diameter and the dependent variable was eGFR. eGFR was estimated from the serum creatinine concentration by using formula eGFR CKD-EPI. Retinal vascular diameter was measured by software SIVA and summarized as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent. CRAE with a diameter <150mikron-m(<25% percentile) defined as a variable small CRAE whereas CRAE with a diameter>168 mikron-m(>75% percentile) defined as large CRAE. CKD stage 3 was defined as eGFR <60 mL / min per 1.73 m2. Results : There were positive correlation between CRAE with eGFR (r:0.311, p:0.007), but there were no significant correlation between CRVE with eGFR (r: 0.02, p: 0.086). The mean CRAE at stage 3 CKD group is smaller (n = 35, p = 0.001) compared to non-CKD group (n = 40), and after controlling for age, systolic and diastolic blood pressure, hypertension, BMI, duration of diabetes, obtained odds ratio of 7.064 between groups is small compared CRAE large CRAE group (CI 1.394 to 32.795, p = 0.005). Conclusion : Our results indicated that there were weak correlation between the decrease in retinal arterioles diameter with eGFR (r: 0.311, p: 0.007), and the small diameter of the retinal arterioles (CRAE<150 mikron-m) have 7 times greater risk of having CKD stage 3 than the diameter of large retinal arterioles (CRAE>168 μm).
Kata Kunci : CRAE, CRVE, eGFR, CKD stage 3, diabetes
