Abstract
Various non-intraocular pressure factors have been identified as possible risk factors for open-angle glaucoma (OAG). However, there is still controversy around the association between OAG and chronic kidney disease (CKD). In this study, we used a nationwide cohort to investigate the risk of OAG in the 12 years following a diagnosis of CKD. This retrospective cohort study included 1,103,302 subjects from the Korean National Health Insurance Service National Sample Cohort database. The CKD group (n = 1318) included patients who were initially diagnosed with CKD between 2003 and 2008. The subjects in the comparison group were matched at a 1:5 ratio using propensity scores. In multivariate Cox regression analysis, a diagnosis of CKD was significantly associated with an increased incidence of OAG (hazard ratio [HR] = 1.546, 95% confidence interval [CI] 1.363–1.754, p < 0.001). Further analysis revealed that the risk of OAG increased with the severity of CKD (mild to moderate CKD [CKD stage 1–3]: HR = 1.280, 95% CI 1.077–1.521, p = 0.005; advanced CKD [CKD stage 4–5]: HR = 1.861, 95% CI 1.589–2.180, p < 0.001). In subgroup analysis, female CKD patients had a greater risk of developing OAG than males, and subjects with CKD aged ≥ 40 years were more likely to develop OAG compared with those aged < 40 years. Our study demonstrates that CKD is a significant risk factor for OAG and that severe CKD is associated with an increased risk of developing OAG.
Highlights
Various non-intraocular pressure factors have been identified as possible risk factors for open-angle glaucoma (OAG)
The risk of developing OAG during the 12-year follow-up period was significantly higher in the chronic kidney disease (CKD) group than the control group (CKD group: adjusted HR = 1.546, 95% confidence intervals (CI) 1.363–1.754, p < 0.001) (Table 2)
Higher CKD stages were associated with a higher risk of OAG (CKD group 1: adjusted HR = 1.280, 95% CI 1.077–1.521, p = 0.005; CKD group 2: adjusted HR = 1.861, 95% CI 1.589–2.180, p < 0.001) (Table 3)
Summary
Various non-intraocular pressure factors have been identified as possible risk factors for open-angle glaucoma (OAG). We used a nationwide cohort to investigate the risk of OAG in the 12 years following a diagnosis of CKD This retrospective cohort study included 1,103,302 subjects from the Korean National Health Insurance Service National Sample Cohort database. Our study demonstrates that CKD is a significant risk factor for OAG and that severe CKD is associated with an increased risk of developing OAG. CKD No Yes Age < 50 50–59 60–69 70–79 > 80 Sex Male Female Income 70–100 percentile (Low) 40–70 percentile > 40 percentile (High) City City resident Rural resident CCI < 3 ≥ 3 Diabetes mellitus No Yes Hypertension No Yes Hyperlipidemia No Yes Stroke No Yes. In light of above, in this study, we investigated the risk of developing OAG after CKD diagnosis using a representative sample of approximately 1.1 million South Koreans from the National Health Insurance ServiceNational Sample Cohort 2002–2015 (NHIS-NSC 2002–2015). We analyzed the risk of developing OAG according to CKD severity
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