ArticleFrontiers in endocrinology2026
Albuminuria, kidney function, and automatically quantified retinal vascular phenotypes in hospitalized adults with type 2 diabetes.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To compare albuminuria and creatinine-based estimated glomerular filtration rate (eGFR) in relation to automatically quantified retinal vascular phenotypes from color fundus photographs in hospitalized adults with type 2 diabetes. Methods: This single-center retrospective study applied clinical, ocular, image-quality, and temporal eligibility criteria. Kidney measurements with a verifiable laboratory-report-to-image interval of no more than 7 days were retained. Exact urinary albumin-to-creatinine ratio (UACR) values were analyzed after log2 transformation; eGFR was recalculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation. Eight vascular outcomes were analyzed at the eye level using patient-clustered robust standard errors. The prespecified primary analyses were separate core models for UACR and eGFR adjusted for age, gender, body mass index, diabetes duration, HbA1c, and systolic blood pressure, with Benjamini-Hochberg false discovery rate (FDR) correction across the eight outcomes within each exposure family. Joint, complete-case, alternative-equation, restricted-range, categorical, spline, and tighter-temporal-window analyses were treated as supportive or exploratory. Results: The final cohort included 658 eyes from 337 patients; the median absolute laboratory-report-to-image interval was 1 day (IQR, 0-1), and 97.9% of eye records were within 3 days. In the primary separate core models, neither UACR nor 2021 CKD-EPI eGFR was associated with any of the eight vascular outcomes after FDR correction (minimum Conclusions: The primary analyses did not demonstrate FDR-significant associations of either kidney marker with the retinal vascular phenotypes. Exploratory complete-case and sensitivity analyses suggested a model-dependent eGFR-related pattern, whereas UACR remained largely null. These cross-sectional findings are hypothesis-generating and require independent longitudinal validation.
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