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Author Notes:

Professor Guillermo E Umpierrez; geumpie@emory.edu

RLC and GEU wrote the initial draft of the manuscript. ME, RLC, EM, ZEZ, and BM served either as study coordinators screening and randomizing research candidates, collecting data or as clinical providers managing patients daily, including weekends, ensuring successful completion of the study protocol. RJG, PV, TI, GDO'K, reviewed and edited the study proposal and manuscript. LP analyzed the data. GEU wrote the initial research proposal, is the guarantor of this work and, as such, had full access to all the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.

We thank the Optomed Aurora Company for the training and use of their retinal camera. We also thank AEYE Health for their online diagnostic platform. These companies had no role in study design, data collection, data interpretation, or manuscript writing.

ME, RLC, EM, ZEZ, BM, GDO'K, JN, RJG, PV, LP, and GEU report no conflicts of interest relevant to this article. PV and GEU are editorial board members of BMJ Open Diabetes Research & Care.

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Research Funding:

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Endocrinology & Metabolism
  • Retinopathy
  • Dialysis
  • Diabetes Complications
  • Quality of Life
  • MACULAR EDEMA
  • SOCIAL DETERMINANTS
  • HEALTH DISPARITIES
  • VISUAL-ACUITY
  • VALIDITY
  • OUTCOMES

Diabetic retinopathy in African-Americans with end-stage kidney disease: a cross-sectional study on prevalence and impact on quality of life

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Journal Title:

BMJ OPEN DIABETES RESEARCH & CARE

Volume:

Volume 11, Number 4

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Type of Work:

Article | Final Publisher PDF

Abstract:

Introduction The prevalence, severity, and quality of life (QoL) impact of diabetic retinopathy (DR) among African-Americans (AAs) with end-stage kidney disease (ESKD) undergoing dialysis are unknown. Research design and methods A cross-sectional study was conducted on 93 AA adults with diabetes and ESKD. The diagnosis of DR was based on a review of medical records and/or a positive photograph with a portable hand-held device reviewed by both artificial intelligence software and a retinal specialist. QoL, physical disability social determinants of health (SDoHs) were assessed by standardized questionnaires. Results The prevalence of DR was 75%, with 33% of participants having mild, 9.6% moderate and 57.4% severe DR. A total of 43% had normal visual acuity; 45% had moderate visual impairment; and 12% had severe visual impairment. We found a high burden of disease, multiple SDoH challenges, and low QoL and general health among patients with ESKD. The presence of DR had no significant impact on physical health and QoL compared with participants without DR. Conclusions DR is present in 75% of AA patients with diabetes and ESKD on haemodialysis. ESKD has a significant burden on general health and QoL; however, DR has a minor additional impact on the overall physical health and QoL in people with ESKD.

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© Author(s) (or their employer(s)) 2023.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
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