Systematic review of ocular and circulatory cytokines linking diabetic retinopathy to kidney disease
Abstract
Background: Diabetic retinopathy (DR) and diabetic kidney disease (DKD) are major microvascular complications of diabetes that contribute substantially to visual disability and renal failure worldwide. Increasing evidence supports the concept of an "eye-kidney axis," whereby inflammatory and angiogenic dysregulation may drive parallel microvascular injury in the retina and kidney. The present systematic review aimed to synthesize current clinical evidence on the association between vitreous and serum cytokines and renal impairment in patients with DR.
Methods: Following PRISMA guidelines, PubMed, Embase, and Web of Science were systematically searched (2005-2025). We included observational human studies investigating vitreous or serum cytokines in adult patients with clinically staged DR and their associations with renal function parameters, including estimated glomerular filtration rate (eGFR) and albuminuria. Data on study characteristics, cytokine profiles, renal metrics, and major findings were extracted. Study quality was assessed using the modified Newcastle-Ottawa Scale. Due to heterogeneity in study design and outcomes, results were synthesized narratively.
Results: Seventeen eligible studies involving patients with type 1 and type 2 diabetes were included. Key cytokines assessed included angiogenic factors (VEGF, PlGF, ANGPTL2/4) and inflammatory mediators (TNF-α, IL-6, IL-17A, MCP-1, sRAGE), measured predominantly using ELISA. Across studies, both vitreous and…
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