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Association between macular degeneration and mild to moderate chronic kidney disease: A nationwide population-based study.

Abstract Chronic kidney disease (CKD) and macular degeneration (MD) are 2 grave diseases leading to significant disability secondary to renal failure and blindness. The 2 diseases share not only common risk factors but also similar pathogenic mechanisms to renal and retinal injuries. Previous epidemiological studies indicated association between these 2 diseases. However, this concept is challenged by recent investigations. Patients with mild to moderate CKD (n = 30,696) between January 1, 1995 and December 31, 2005 were selected from the Taiwan National Health Insurance Database. Controls (n = 122,784) were matched by age, gender, diabetes mellitus type 2, and hypertension status (1:4 ratios). The risk of MD was compared between the 2 groups. The mean age of patients was 54.9 ± 15.7 years. The proportion of MD was 2.7% in mild to moderate CKD patients and 1.9% in normal controls (P < 0.001); and, 0.39% and 0.26% (P < 0.001) in advanced MD. Mild to moderate CKD patients had higher risk for MD [adjusted odds ratio (OR), 1.301; 95% confidence interval (CI), 1.200-1.411; P < 0.001] than normal renal function subjects. The association was more pronounced for advanced MD. From all age strata (10 years increase), the presence of CKD in those patients aged less than 40 years had highest OR for all MD (OR = 2.125, 95% CI: 1.417-3.186, P < 0.001). The results were consistent in interaction terms, highlighting the importance of CKD in young age patient for risk of MD. The high risk for MD in mild to moderate CKD patients remains significant after adjustment for personal habits (alcohol drinking and smoking, model 1; OR: 1.371; 95% CI: 1.265-1.486; P < 0.001), comorbidities (dyslipidemia, cerebrovascular disease, and peripheral vascular disease, model 2; OR: 1.369; 95% CI: 1.264-1.484; P < 0.001) and all these factors (model 3; OR: 1.320, 95% CI: 1.218-1.431, P < 0.001). This association was consistent in the subanalysis, excluding those patients with diabetic retinopathy. Proper diagnosis and timely intervention should be warranted to retard visual loss of these patients.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28296786
OWN - NLM
STAT- MEDLINE
DA  - 20170315
DCOM- 20170410
LR  - 20170410
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 11
DP  - 2017 Mar
TI  - Association between macular degeneration and mild to moderate chronic kidney
      disease: A nationwide population-based study.
PG  - e6405
LID - 10.1097/MD.0000000000006405 [doi]
AB  - Chronic kidney disease (CKD) and macular degeneration (MD) are 2 grave diseases
      leading to significant disability secondary to renal failure and blindness. The 2
      diseases share not only common risk factors but also similar pathogenic
      mechanisms to renal and retinal injuries. Previous epidemiological studies
      indicated association between these 2 diseases. However, this concept is
      challenged by recent investigations. Patients with mild to moderate CKD (n =
      30,696) between January 1, 1995 and December 31, 2005 were selected from the
      Taiwan National Health Insurance Database. Controls (n = 122,784) were matched by
      age, gender, diabetes mellitus type 2, and hypertension status (1:4 ratios). The 
      risk of MD was compared between the 2 groups. The mean age of patients was 54.9
      +/- 15.7 years. The proportion of MD was 2.7% in mild to moderate CKD patients
      and 1.9% in normal controls (P &lt; 0.001); and, 0.39% and 0.26% (P &lt; 0.001) in
      advanced MD. Mild to moderate CKD patients had higher risk for MD [adjusted odds 
      ratio (OR), 1.301; 95% confidence interval (CI), 1.200-1.411; P &lt; 0.001] than
      normal renal function subjects. The association was more pronounced for advanced 
      MD. From all age strata (10 years increase), the presence of CKD in those
      patients aged less than 40 years had highest OR for all MD (OR = 2.125, 95% CI:
      1.417-3.186, P &lt; 0.001). The results were consistent in interaction terms,
      highlighting the importance of CKD in young age patient for risk of MD. The high 
      risk for MD in mild to moderate CKD patients remains significant after adjustment
      for personal habits (alcohol drinking and smoking, model 1; OR: 1.371; 95% CI:
      1.265-1.486; P &lt; 0.001), comorbidities (dyslipidemia, cerebrovascular disease,
      and peripheral vascular disease, model 2; OR: 1.369; 95% CI: 1.264-1.484; P &lt;
      0.001) and all these factors (model 3; OR: 1.320, 95% CI: 1.218-1.431, P &lt;
      0.001). This association was consistent in the subanalysis, excluding those
      patients with diabetic retinopathy. Proper diagnosis and timely intervention
      should be warranted to retard visual loss of these patients.
FAU - Chen, Chun-Yu
AU  - Chen CY
AD  - aDepartment of Nephrology, Chang Gung Memorial Hospital, Keelung bCollege of
      Medicine, Chang Gung University, Taoyuan cCommunity Medicine Research Center,
      Keelung Chang Gung Memorial Hospital dDepartment of General Surgery eDepartment
      of Ophthalmology, Chang Gung Memorial Hospital, Keelung fDepartment of Chinese
      Medicine, College of Medicine, Chang Gung University, Taoyuan gDepartment of
      Nephrology, Chang Gung Memorial Hospital, Linkuo, Taiwan.
FAU - Dai, Ciou-Sia
AU  - Dai CS
FAU - Lee, Chin-Chan
AU  - Lee CC
FAU - Shyu, Yu-Chiau
AU  - Shyu YC
FAU - Huang, Ting-Shuo
AU  - Huang TS
FAU - Yeung, Ling
AU  - Yeung L
FAU - Sun, Chi-Chin
AU  - Sun CC
FAU - Yang, Huang-Yu
AU  - Yang HY
FAU - Wu, I-Wen
AU  - Wu IW
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Female
MH  - Health Behavior
MH  - Humans
MH  - Macular Degeneration/*complications
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Renal Insufficiency, Chronic/*complications
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Taiwan/epidemiology
PMC - PMC5369941
EDAT- 2017/03/16 06:00
MHDA- 2017/04/11 06:00
CRDT- 2017/03/16 06:00
AID - 10.1097/MD.0000000000006405 [doi]
AID - 00005792-201703170-00067 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Mar;96(11):e6405. doi: 10.1097/MD.0000000000006405.

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