原发性开角型青光眼与慢性肾脏病风险增加。

Primary Open-angle Glaucoma and Increased Risk of Chronic Kidney Disease.

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam.

School of Pharmacy, Sungkyunkwan University, Suwon.

出版信息

J Glaucoma. 2019 Dec;28(12):1067-1073. doi: 10.1097/IJG.0000000000001390.

DOI:10.1097/IJG.0000000000001390

PMID:31633620

Abstract

PRECIS

The association between primary open-angle glaucoma (POAG) and subsequent development of chronic kidney disease (CKD) was investigated using a nationwide, population-based, retrospective cohort in South Korea. POAG increases the risk of subsequent CKD development.

PURPOSE

The purpose of this study was to investigate the risk of subsequent CKD development in patients with POAG.

METHODS

In this nationwide, population-based longitudinal cohort, 1,025,340 beneficiaries in the 2002-2013 Korean National Health Insurance database were included. We identified patients with incident POAG and evaluated the risk of subsequent CKD development using diagnostic codes from the database after 2-year wash-out periods. We applied time-varying covariate Cox regression analyses to determine the effect of POAG on the development of CKD: Model 1 included only POAG as a time-varying covariate; Model 2 included Model 1 and demographic information; and Model 3 included Model 2, comorbidity, comedication, and the Charlson Comorbidity Index score.

RESULTS

The fixed cohort included 478,303 eligible subjects, and of these subjects, 1749 suffered incident POAG, and 3157 developed CKD. POAG was associated with an increased risk of CKD development [hazard ratio (HR)=7.63; 95% confidence interval (CI), 5.89-9.87] in Model 1; HR=3.54 (95% CI, 2.73-4.58) in Model 2; and HR=2.90 (95% CI, 2.24-3.76) in Model 3].

CONCLUSION

POAG increased the risk of subsequent CKD in the general population, suggesting that POAG and CKD might share a common pathogenic mechanism.

摘要

本研究通过韩国全国范围内的基于人群的回顾性队列研究，探讨了原发性开角型青光眼（POAG）与慢性肾脏病（CKD）后续发展之间的关系。POAG 增加了后续 CKD 发展的风险。

目的

本研究旨在探讨 POAG 患者发生 CKD 的风险。

方法

在这项全国范围内基于人群的纵向队列研究中，纳入了 2002 年至 2013 年韩国国家健康保险数据库中的 1025340 名受益患者。我们确定了患有新发 POAG 的患者，并在 2 年洗脱期后使用数据库中的诊断代码评估了后续 CKD 发展的风险。我们应用时变协变量 Cox 回归分析来确定 POAG 对 CKD 发展的影响：模型 1 仅将 POAG 作为时变协变量；模型 2 包含模型 1 和人口统计学信息；模型 3 包含模型 2、合并症、合并用药和 Charlson 合并症指数评分。

结果

固定队列纳入了 478303 名符合条件的患者，其中 1749 名患者患有新发 POAG，3157 名患者发生 CKD。在模型 1 中，POAG 与 CKD 发展的风险增加相关[危险比（HR）=7.63；95%置信区间（CI），5.89-9.87]；在模型 2 中，HR=3.54（95%CI，2.73-4.58）；在模型 3 中，HR=2.90（95%CI，2.24-3.76）。