Ballester Dolz Pablo, Ålander Karin, Smedberg Petra, Vihlborg Per, Bryngelsson Ing-Liss, Westerlund Jessica, Makdoumi Karim
Department of Ophthalmology, Faculty of Medicine and Health, Orebro University, Orebro, Sweden.
School of Medical Sciences, Orebro University, Orebro, Sweden.
Clin Exp Ophthalmol. 2025 Mar;53(2):209-217. doi: 10.1111/ceo.14464. Epub 2024 Nov 17.
Chronic kidney disease (CKD) is a growing health issue that is becoming more prevalent globally, increasing financial cost on healthcare systems. The purpose of this study is to investigate the incidence of eye diseases in patients diagnosed with CKD in Sweden and to evaluate which eye diseases are most likely to develop.
A longitudinal population-based retrospective case-control study was conducted including all individuals diagnosed with chronic kidney disease during the time period 2001-2019. A total of 19 455 cases and 38 890 controls were included. For each case, two controls were matched with the same sex, age, and county of residence.
CKD patients had a significantly higher risk of contracting any eye disease compared to individuals without kidney disease HR 1.73 (CI 1.67-1.79), with an elevated risk for all blocks of diagnoses except for glaucoma HR 0.95 (CI 0.85-1.06). However, this condition developed earlier in cases than in controls. Subanalyses showed an increased risk for chronic eye disease patients to develop cataract HR 1.70 (CI 1.63-1.78), other retinal disorders HR 1.86 (CI 1.72-2.02), and retinal vascular occlusions HR 2.08 (CI 1.73-2.51). In general, diagnosis of an eye disease occurred earlier in cases than controls.
The results from this study suggest that CKD patients have an increased risk to develop eye disease. Ocular disease seems to develop considerably earlier in CKD, even without staging the severity of the disease, with particularly high risk of developing retinal diseases and cataracts. Screening for eye disease in CKD should be considered.
慢性肾脏病(CKD)是一个日益严重的健康问题,在全球范围内越来越普遍,增加了医疗系统的经济成本。本研究的目的是调查瑞典被诊断为CKD的患者眼部疾病的发病率,并评估哪些眼部疾病最有可能发生。
进行了一项基于人群的纵向回顾性病例对照研究,纳入了2001年至2019年期间所有被诊断为慢性肾脏病的个体。共纳入19455例病例和38890例对照。对于每例病例,匹配两名性别、年龄和居住县相同的对照。
与无肾脏疾病的个体相比,CKD患者患任何眼部疾病的风险显著更高,风险比(HR)为1.73(可信区间[CI]为1.67 - 1.79),除青光眼外,所有诊断组的风险均升高,青光眼的HR为0.95(CI为0.85 - 1.06)。然而,这种情况在病例中比在对照中出现得更早。亚组分析显示,慢性眼病患者患白内障的风险增加,HR为1.70(CI为1.63 - 1.78),患其他视网膜疾病的风险增加,HR为1.86(CI为1.72 - 2.02),患视网膜血管阻塞的风险增加,HR为2.08(CI为1.73 - 2.51)。一般来说,病例中眼部疾病的诊断比对照更早出现。
本研究结果表明,CKD患者患眼部疾病的风险增加。眼部疾病在CKD患者中似乎出现得相当早,即使不考虑疾病的严重程度分期,患视网膜疾病和白内障的风险尤其高。应考虑对CKD患者进行眼部疾病筛查。