Departments of Ophthalmology.
Health Information and Management, and.
Retina. 2021 Oct 1;41(10):2140-2147. doi: 10.1097/IAE.0000000000003151.
To examine the incidence and risk of retinal artery occlusion (RAO) in patients who have undergone dialysis in Korea.
A nationwide, population-based study using South Korean national health insurance data from 2004 to 2013 was used for analysis. All patients who began dialysis between 2004 and 2013 and the same number of control subjects were selected via propensity score matching. The incidence of RAO in the dialysis and control cohorts was calculated for 2004 to 2013 using washout data from 2003. The multivariable Cox proportional hazards model was used to evaluate the risk of developing RAO in dialysis patients. Cumulative RAO incidence curves were generated using the Kaplan-Meier method. Whether dialysis modalities influenced the incidence of RAO was also evaluated.
Seventy-six thousand seven hundred and eighty-two end-stage renal disease patients on dialysis were included in the dialysis cohort, and 76,782 individuals were included in the control cohort. During the study period, 293 patients in the dialysis cohort and 99 patients in the control cohort developed RAO. The person-years incidence of RAO was significantly higher in the dialysis cohort than in the control cohort (dialysis = 1.1/1,000 person-years; control = 0.3/1,000 person-years; P < 0.001). The incidence of RAO was not significantly different between the two methods of dialysis (hemodialysis vs. peritoneal dialysis; P = 0.25, log-rank test).
The current study provided epidemiological evidence that undergoing dialysis for end-stage renal disease was associated with an increased risk of developing RAO. The incidence of RAO rapidly increased as the duration of dialysis increased. These results strengthen the significant role of the renal function in retinal vascular disease.
研究韩国透析患者视网膜动脉阻塞(RAO)的发病率和风险。
采用韩国国家健康保险数据,进行了一项全国性的基于人群的研究,时间范围为 2004 年至 2013 年。通过倾向评分匹配,选择了在 2004 年至 2013 年间开始透析的所有患者和相同数量的对照组。使用 2003 年的洗脱数据,计算了 2004 年至 2013 年透析组和对照组中 RAO 的发病率。采用多变量 Cox 比例风险模型评估透析患者发生 RAO 的风险。采用 Kaplan-Meier 方法生成累积 RAO 发生率曲线。还评估了透析方式是否影响 RAO 的发生率。
纳入了 76782 名接受透析的终末期肾病患者作为透析组,纳入了 76782 名个体作为对照组。在研究期间,透析组有 293 名患者和对照组有 99 名患者发生了 RAO。透析组的 RAO 人年发病率明显高于对照组(透析组=1.1/1000 人年;对照组=0.3/1000 人年;P<0.001)。两种透析方法(血液透析与腹膜透析)的 RAO 发生率无显著差异(P=0.25,对数秩检验)。
本研究提供了流行病学证据,表明接受终末期肾病透析与发生 RAO 的风险增加相关。随着透析时间的延长,RAO 的发病率迅速增加。这些结果强化了肾功能在视网膜血管疾病中的重要作用。