INVESTIGATIONS ON THE EFFECT OF FLUORESCEIN ANGIOGRAPHY ON RENAL FUNCTION IN DIABETIC RETINOPATHY PATIENTS

Fluorescein angiography is a commonly used procedure for diagnosing and staging diabetic retinopathy. Diabetic retinopathy is one of the major complications of type 2 Diabetes Mellitus (DM). Patients with diabetic retinopathy are likely to have Chronic Kidney Disease (CKD) as degree of retinopathy correlates with the degree of nephropathy in diabetes. Contrast Induced Nephropathy (CIN) is now defined as an increase of 25% or more in serum creatinine, or an absolute increase of 0.5 mg/dl or more from baseline value, at 48-72 h after exposure to Contrast Media (CM). Although several studies reported the effect of iodinated contrast media on kidney functions especially in diabetic CKD patients, very few conflicting data had been published regarding fluorescein (non-iodinated dye) induced renal injury. Contradictory studies have been reported regarding the effect of fluorescein angiography on renal functions using serum creatinine, estimated GFR (eGFR), so the current research study has been taken to investigate the actual effect of fluorescein on kidney function based on the serum creatinine and early sensitive acute kidney injury biomarkers i.e. Serum Cystatin-C level in pre and post angiography samples of diabetic patients. A total of 70 diabetic patients (38 male and 32 female) met the inclusion criteria and were studied; the mean age of participants were 53.1 ± 9.2 years; range 30-72 years (male, 58.3 ± 9.5 and female, and 45.7 ± 9.0). Mean of Serum Creatinine before fluorescein angiography was 0.89±0.20 mg/dl (male, 0.85 ± 0.20 and female, 0.89 ± 0.23), and after angiography was 0.92 ±0.23 mg/dl (male, 0.92 ± 0.62 and female, 0.93 ± 0.22). Seven patients (20.5%) had an increase in Serum Creatinine from baseline within 72 hours of fluorescein administration (5 male and 2 female). The present study observed no significant effect of fluorescein angiography on serum creatinine and Serum Cystatin-C level.