Xue Can Can, Sim Ralene, Chee Miao Li, Yu Marco, Wang Ya Xing, Rim Tyler Hyungtaek, Hyung Park Kyu, Woong Kang Se, Song Su Jeong, Nangia Vinay, Panda-Jonas Songhomitra, Wang Ning Li, Hao Jie, Zhang Qing, Cao Kai, Sasaki Mariko, Harada Sei, Toru Takebayashi, Ryo Kawasaki, Raman Rajiv, Surya Janani, Khan Rehana, Bikbov Mukharram, Wong Ian Y, Cheung Chui Ming Gemmy, Jonas Jost B, Cheng Ching-Yu, Tham Yih-Chung
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Ophthalmology. 2024 Jun;131(6):692-699. doi: 10.1016/j.ophtha.2023.12.030. Epub 2023 Dec 29.
Chronic kidney disease (CKD) may elevate susceptibility to age-related macular degeneration (AMD) because of shared risk factors, pathogenic mechanisms, and genetic polymorphisms. Given the inconclusive findings in prior studies, we investigated this association using extensive datasets in the Asian Eye Epidemiology Consortium.
Cross-sectional study.
Fifty-one thousand two hundred fifty-three participants from 10 distinct population-based Asian studies.
Age-related macular degeneration was defined using the Wisconsin Age-Related Maculopathy Grading System, the International Age-Related Maculopathy Epidemiological Study Group Classification, or the Beckman Clinical Classification. Chronic kidney disease was defined as estimated glomerular filtration rate (eGFR) of less than 60 ml/min per 1.73 m. A pooled analysis using individual-level participant data was performed to examine the associations between CKD and eGFR with AMD (early and late), adjusting for age, sex, hypertension, diabetes, body mass index, smoking status, total cholesterol, and study groups.
Odds ratio (OR) of early and late AMD.
Among 51 253 participants (mean age, 54.1 ± 14.5 years), 5079 had CKD (9.9%). The prevalence of early AMD was 9.0%, and that of late AMD was 0.71%. After adjusting for confounders, individuals with CKD were associated with higher odds of late AMD (OR, 1.46; 95% confidence interval [CI], 1.11-1.93; P = 0.008). Similarly, poorer kidney function (per 10-unit eGFR decrease) was associated with late AMD (OR, 1.12; 95% CI, 1.05-1.19; P = 0.001). Nevertheless, CKD and eGFR were not associated significantly with early AMD (all P ≥ 0.149).
Pooled analysis from 10 distinct Asian population-based studies revealed that CKD and compromised kidney function are associated significantly with late AMD. This finding further underscores the importance of ocular examinations in patients with CKD.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
慢性肾脏病（CKD）可能因共同的危险因素、致病机制和基因多态性而增加年龄相关性黄斑变性（AMD）的易感性。鉴于既往研究结果尚无定论，我们利用亚洲眼流行病学联盟的大量数据集对这种关联进行了调查。
横断面研究。
来自10项不同的基于人群的亚洲研究的51253名参与者。
年龄相关性黄斑变性采用威斯康星年龄相关性黄斑病变分级系统、国际年龄相关性黄斑病变流行病学研究组分类或贝克曼临床分类来定义。慢性肾脏病定义为估算肾小球滤过率（eGFR）低于60 ml/（min·1.73 m²）。使用个体水平的参与者数据进行汇总分析，以检验CKD和eGFR与AMD（早期和晚期）之间的关联，并对年龄、性别、高血压、糖尿病、体重指数、吸烟状况、总胆固醇和研究组进行校正。
早期和晚期AMD的比值比（OR）。
在51253名参与者（平均年龄54.1±14.5岁）中，5079人患有CKD（9.9%）。早期AMD的患病率为9.0%，晚期AMD的患病率为0.71%。校正混杂因素后，CKD患者发生晚期AMD的几率更高（OR，1.46；95%置信区间[CI]，1.11-1.93；P = 0.008）。同样，肾功能越差（eGFR每降低10个单位）与晚期AMD相关（OR，1.12；95%CI，1.05-1.19；P = 0.001）。然而，CKD和eGFR与早期AMD无显著关联（所有P≥0.149）。
来自10项不同的基于亚洲人群研究的汇总分析显示，CKD和肾功能受损与晚期AMD显著相关。这一发现进一步强调了对CKD患者进行眼部检查的重要性。
在本文末尾的脚注和披露中可能会有专有或商业披露信息。
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