Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Center for Public Healthcare, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Sci Rep. 2022 Mar 1;12(1):3423. doi: 10.1038/s41598-022-07190-8.
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.
各种非眼压因素已被确定为开角型青光眼（OAG）的可能危险因素。然而，OAG 与慢性肾脏病（CKD）之间的关联仍存在争议。在这项研究中，我们使用全国性队列研究调查了 CKD 诊断后 12 年内 OAG 的发病风险。这项回顾性队列研究纳入了来自韩国国家健康保险服务-国家样本队列数据库的 1103302 名受试者。CKD 组（n=1318）包括 2003 年至 2008 年间最初诊断为 CKD 的患者。对照组采用倾向评分匹配了 1:5 的比例。在多变量 Cox 回归分析中，CKD 的诊断与 OAG 发病率的增加显著相关（风险比[HR] = 1.546，95%置信区间[CI] 1.363-1.754，p < 0.001）。进一步分析显示，OAG 的发病风险随 CKD 严重程度的增加而增加（轻度至中度 CKD [CKD 1-3 期]：HR = 1.280，95%CI 1.077-1.521，p = 0.005；晚期 CKD [CKD 4-5 期]：HR = 1.861，95%CI 1.589-2.180，p < 0.001）。在亚组分析中，女性 CKD 患者发生 OAG 的风险高于男性，年龄≥40 岁的 CKD 患者发生 OAG 的风险高于年龄<40 岁的患者。本研究表明 CKD 是 OAG 的一个重要危险因素，严重 CKD 与发生 OAG 的风险增加相关。
