Does an Association Exist Between Pseudoexfoliation Syndrome and Chronic Kidney Disease?

Abstract

To determine whether pseudoexfoliation (PEX) syndrome is associated with an increased risk of chronic kidney disease (CKD). In this cross-sectional study, 271 consecutive patients were recruited into 3 study groups---PEX syndrome (n=86), primary open-angle glaucoma (POAG) (n=91), and nonglaucoma controls (n=94)---and underwent serum creatinine testing to determine their glomerular filtration rates (eGFR). Repeat eGFR and testing for urine albumin:creatinine ratio were performed a minimum of 3 months later if the initial eGFR was less than 60 mL/min/1.73 m. CKD was diagnosed if both eGFR levels were less than 45 mL/min/1.73 m or both eGFR levels were less than 60 mL/min/1.73 m and the urine albumin:creatinine ratio was greater than 2.0. The main outcome measure was the rate of CKD for each group. The CKD rate for the control group (11.7%, 11 of 94) was statistically higher than the PEX (3.5%, 3 of 86, P=0.050) and the POAG (3.3%, 3 of 91, P=0.049) groups. However, there was a significantly higher rate of diabetes mellitus, a known risk factor for CKD, in the control group than the PEX and POAG groups. After adjusting for the differences in the rate of diabetes mellitus and mean age (another risk factor for CKD) between groups, a multivariate logistic regression analysis showed that none of the study groups was a predictor of an increased rate of CKD. A post-hoc analysis performed with all patients with diabetes mellitus removed also showed no statistical difference between groups for CKD rates and mean eGFR levels. Compared with age-matched patients with POAG and nonglaucoma controls, PEX syndrome was not found to be associated with an increased prevalence of CKD.