Ocular Complications in Type 2 Diabetes Mellitus Patients with Chronic Kidney Disease: A Retrospective Cohort Study based on the Indonesian National Health Insurance Data
TL;DR
T2DM patients with retinal disorders, vitreous body disorders, globe abnormalities, cataracts, and glaucoma showed markedly higher risks of developing CKD, underscoring the need for integrated screening and management.
Abstract
The global prevalence of type 2 diabetes mellitus (T2DM) is projected to rise dramatically. Southeast Asia regions will predictably face a 73% increase by 2050, exacerbating risks of microvascular complications like chronic kidney disease (CKD) and ocular disorders. This study aims to investigate the association between ocular comorbidity in type 2 diabetes mellitus (T2DM) patients with a chronic kidney disease (CKD) according to the Indonesian National Health Insurance data. This retrospective cohort study analyzed 7,581 T2DM patients (11.4% with CKD) from Indonesian National Health Insurance (NHI) database year 2016–2023. Odds ratios (OR) and hazard ratios (HR) for ocular diagnoses (ICD-10 codes) were calculated using contingency tables and cox regression after propensity score matching (PSM) for age and sex. Other retinal disorders (OR: 2.96, 95% CI: 2.22–3.96), vitreous body disorders (OR: 2.92, 95% CI: 2.09–4.08), and other cataracts (OR: 1.70, 95% CI: 1.35–2.13) had significantly higher odds of CKD occurrence in T2DM patients. Conversely, refractive errors showed a lower OR (0.79, 95% CI: 0.64–0.99). Adjusted HRs confirmed elevated risks of CKD in T2DM patients with other retinal disorders (HR: 2.03) and vitreous body disorders (HR: 1.72). T2DM patients with retinal disorders, vitreous body disorders, globe abnormalities, cataracts, and glaucoma showed markedly higher risks of developing CKD, underscoring the need for integrated screening and management.