Chiu Shin-Lin, Nfor Oswald Ndi, Chen Chiu-Liang, Tantoh Disline Manli, Lu Wen Yu, Chen Pei-Hsin, Liaw Yung-Po
Department of Ophthalmology, Changhua Christian Hospital, 500, Changhua City, Taiwan.
College of Nursing and Health Sciences, Da-Yeh University, 515006, Changhua County, Taiwan.
BMC Geriatr. 2024 Feb 19;24(1):174. doi: 10.1186/s12877-024-04740-9.
The kidney and eyes share common pathways and are thought to be closely connected. Chronic kidney disease and major eye diseases, such as cataract and glaucoma, are strongly associated with age. However, further investigation is needed to understand the joint impact of age and kidney diseases on eye diseases. In this study, we assessed the risk of eye diseases in relation to age and kidney failure in Taiwanese adults.
Our study included 127,561 cancer-free volunteers aged 30 to 70 years who participated in the Taiwan Biobank (TWB) project from 2008 to 2020. Information on the main exposures (kidney failure and age) and the outcome (eye diseases, including glaucoma, cataract, xerophthalmia, and retinal detachment) was collected through questionnaires.
In general, kidney failure and older age were independently associated with a higher risk of eye, particularly cataract and retinal detachment: prevalence odds ratio (POR); 95% confidence interval (CI) = 2.480; 1.635-3.761 for cataract and 3.885; 1.968-7.666 for retinal detachment. A significant interaction between kidney failure and age on cataract was observed (p-value = 0.0002). Age-stratified analysis revealed a higher risk of cataract among patients with kidney failure aged below 50 (POR = 6.534; 95% CI = 2.493-17.124) and between 50 and 60 years (POR = 3.957; 95%CI = 1.986-7.881). Combining kidney failure and age (reference: no kidney failure and age < 50 years), kidney failure in all age groups was associated with a higher risk of cataract. The PORs; 95% CIs were 10.725; 4.227-27.211 for patients below 50 years, 28.487; 14.270-56.866 for those aged 50-60 years, and 43.183; 24.434-72.824 for those > 60 years. Combining cataract and age (reference: no cataract and age < 50 years), patients below 50 years had the highest risk of kidney failure (POR; 95% CI = 9.510; 3.722-24.297).
Our study suggests that age and kidney failure may jointly contribute to eye diseases, particularly cataract. The association between cataract and kidney failure could be bidirectional, especially in individuals below 50 years. This significant bidirectional relationship underscores the need for screening patients with cataract for kidney failure and vice versa, particularly in younger adults.
肾脏和眼睛有着共同的通路，被认为联系紧密。慢性肾脏病与白内障和青光眼等主要眼部疾病都与年龄密切相关。然而，仍需进一步研究以了解年龄和肾脏疾病对眼部疾病的联合影响。在本研究中，我们评估了台湾成年人中年龄和肾衰竭与眼部疾病风险的关系。
我们的研究纳入了127,561名年龄在30至70岁之间、未患癌症的志愿者，他们于2008年至2020年参与了台湾生物银行（TWB）项目。通过问卷收集了主要暴露因素（肾衰竭和年龄）以及结局（眼部疾病，包括青光眼、白内障、干眼症和视网膜脱离）的信息。
总体而言，肾衰竭和高龄独立地与更高的眼部疾病风险相关，尤其是白内障和视网膜脱离：白内障的患病率比值比（POR）；95%置信区间（CI）=2.480；1.635 - 3.761，视网膜脱离的为3.885；1.968 - 7.666。观察到肾衰竭和年龄对白内障有显著的交互作用（p值 = 0.0002）。年龄分层分析显示，50岁以下（POR = 6.534；95% CI = 2.493 - 17.124）和50至60岁（POR = 3.957；95% CI = 1.986 - 7.881）的肾衰竭患者患白内障的风险更高。将肾衰竭和年龄相结合（参照：无肾衰竭且年龄 < 50岁），所有年龄组的肾衰竭都与更高的白内障风险相关。50岁以下患者的PORs；95% CIs为10.725；4.227 - 27.211，50 - 60岁患者的为28.487；14.270 - 56.866，60岁以上患者的为43.183；24.434 - 72.824。将白内障和年龄相结合（参照：无白内障且年龄 < 50岁），50岁以下患者患肾衰竭的风险最高（POR；95% CI = 9.510；3.722 - 24.297）。
我们的研究表明，年龄和肾衰竭可能共同导致眼部疾病，尤其是白内障。白内障与肾衰竭之间的关联可能是双向的，特别是在50岁以下的个体中。这种显著的双向关系强调了对白内障患者进行肾衰竭筛查以及反之对肾衰竭患者进行白内障筛查的必要性，尤其是在年轻成年人中。
