Abstract
This paper investigated the incidence and risk of newly diagnosed glaucoma after the initiation of maintenance dialysis in Taiwan. A case–control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. There were 3949 patients with dialysis in the study group and 78,980 non-dialysis subjects matched by age and sex in the comparison group. The incidence of newly diagnosed glaucoma after the initiation of maintenance dialysis was analyzed based on the diagnostic code for glaucoma. Patients with dialysis had a higher risk of glaucoma (adjusted hazard ratio (aHR): 1.270; 95% confidence interval (CI): 1.035–1.560) than patients without dialysis. The incidence rate of glaucoma was 8.18 per 10,000 person months in the dialysis group, which was higher than that in the non-dialysis group (5.01 per 10,000 person months). Patients with dialysis exhibited a significantly higher risk of angle-closure glaucoma (ACG) (aHR: 1.550; 95% CI: 1.074–2.239). In contrast, there was no significant risk of developing open-angle glaucoma or normal-tension glaucoma in dialysis patients. Our data suggest that dialysis patients are more susceptible to ACG. Regular ophthalmic examinations may be useful in patients with dialysis to identify high-risk individuals with glaucoma, and preventive measures can be applied to avoid permanent vision loss as soon as intraocular pressure (IOP) elevation is identified.
Highlights
End-stage renal disease (ESRD) is a chronic condition in which patients rely on either maintenance dialysis or a renal transplant, and it is associated with a significant socioeconomic burden
We identified the comorbidities of each participant to evaluate their health status and to investigate the correlation between glaucoma and comorbidities
The number of people diagnosed with hypertension, diabetes mellitus, ischemic heart diseases, hyperlipidemia, congestive heart failure, cerebrovascular disease, dementia, non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy was significantly higher in the dialysis group than in the non-dialysis group
Summary
End-stage renal disease (ESRD) is a chronic condition in which patients rely on either maintenance dialysis or a renal transplant, and it is associated with a significant socioeconomic burden. Taiwan has been reported to have the highest incidence (493 per million) and prevalence (3392 per million) of treated. ESRD in the world [1]; 87.5% of these patients receive hemodialysis (HD), while 8.5% receive peritoneal dialysis (PD) [2,3]. In 2010, it was estimated that 2.6 million individuals worldwide received renal replacement therapy, and the number is estimated to be more than 5.4 million by 2030 [4]. Res. Public Health 2020, 17, 6774; doi:10.3390/ijerph17186774 www.mdpi.com/journal/ijerph
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