BACKGROUND Administering anti-vascular endothelial growth factor (anti-VEGF) by intraocular injection has been shown to have a safe systemic profile. Nevertheless, incidents of acute kidney injury following anti-VEGF injection have been reported. We assessed the long-term effect of multiple intravitreal anti-VEGF injections on measures of renal function in patients with diabetes including rate of change of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR). METHODS A retrospective review of patients receiving diabetic macular oedema (DMO) treatment was undertaken. Serum creatinine, ACR, number of intravitreal anti-VEGF injections and clinical characteristics were collected from electronic healthcare records (EHR). A co-efficient of eGFR and ACR change with time was calculated over a mean duration of 2.6 years. Regression modelling was used to assess variation in the number of anti-VEGF injections and change in eGFR and ACR. RESULTS The EHR of 85 patients with DMO (59% male, 78% type 2 diabetes mellitus [T2DM]) were reviewed. On average, 26.8 intravitreal anti-VEGF injections were given per patient over a mean duration of 31 months. No association between increasing number of anti-VEGF injections and rate of eGFR decline (beta = 0.04, 95% confidence intervals [CI]: - 0.02, 0.09; p = 0.22) or ACR change over time (beta = 0.02, CI: - 0.19, 0.23; p = 0.86) was detected, following adjustment for hypertension, cerebrovascular disease, T2DM, and medications taken. CONCLUSION Our data suggests regular long-term intravitreal VEGF inhibition does not significantly alter the rate of change in eGFR and/or ACR with increasing number of treatment injections.

中文翻译：

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长期玻璃体内抗血管内皮生长因子注射液对有或无糖尿病肾病患者肾功能的评估。

背景技术已经证明通过眼内注射施用抗血管内皮生长因子（抗VEGF）具有安全的全身性特征。然而，已经报道了抗VEGF注射后的急性肾损伤事件。我们评估了多次玻璃体内抗VEGF注射对糖尿病患者肾功能的长期影响，包括估计的肾小球滤过率（eGFR）和尿白蛋白与肌酐比（ACR）的变化率。方法回顾性分析接受糖尿病性黄斑水肿（DMO）治疗的患者。血清肌酐，ACR，玻璃体内抗VEGF注射次数和临床特征均从电子医疗记录（EHR）中收集。计算了平均2.6年的eGFR和ACR随时间变化的系数。回归模型用于评估抗VEGF注射数量的变化以及eGFR和ACR的变化。结果回顾了85例DMO患者的EHR（男性59％，2型糖尿病[T2DM] 78％）。平均每位患者在平均31个月的时间内注射26.8次玻璃体内抗VEGF。抗VEGF注射数量的增加与eGFR下降率（β= 0.04，95％置信区间[CI]：-0.02，0.09; p = 0.22）或ACR随时间变化（β= 0.02，CI：-之间没有关联在对高血压，脑血管疾病，T2DM和所用药物进行了调整之后，检测到了0.19，0.23; p = 0.86）。结论我们的数据表明，定期的长期玻璃体内VEGF抑制不会随着治疗注射次数的增加而显着改变eGFR和/或ACR的变化率。