There is limited knowledge on the prevalence and risk factors of
diabetic retinopathy (DR) in dialysis patients. We have investigated the association between
diabetes mellitus and
lipid-related
biomarkers and retinopathy in
hemodialysis patients. We reviewed 1,255
hemodialysis patients with
type 2 diabetes mellitus (T2DM) who participated in the German Diabetes and Dialysis Study (4D Study). Associations between categorical clinical, biochemical variables and
diabetic retinopathy were examined by logistic regression. On average, patients were 66 ± 8 years of age, 54% were male and the HbA1c was 6.7% ± 1.3%. DR, found in 71% of the patients, was significantly and positively associated with fasting
glucose, HbA1c, time on dialysis, age, systolic blood pressure, body mass index and the prevalence of other microvascular diseases (e.g. neuropathy). Unexpectedly, DR was associated with high
HDL cholesterol and high
apolipoproteins AI and AII. Patients with
coronary artery disease were less likely to have DR. DR was not associated with gender, smoking, diastolic blood pressure,
VLDL cholesterol,
triglycerides, and
LDL cholesterol. In summary, the prevalence of DR in patients with
type 2 diabetes mellitus requiring
hemodialysis is higher than in patients suffering from T2DM, who do not receive
hemodialysis. DR was positively related to systolic blood pressure (BP), glucometabolic control, and, paradoxically,
HDL cholesterol. This data suggests that
glucose and blood pressure control may delay the development of DR in patients with
diabetes mellitus on dialysis.