Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

Abstract

Background: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. Methods: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries. On the basis of the ambulatory care records, those diagnosed with CKD (ICD-9-CM code: 585) during the follow-up period were enrolled as CKD patients after careful evaluation. Each patient with CKD was age- and gender-matched with 4 individuals who did not have CKD. Cox regression models were applied to compare the hazard of cataract surgery in individuals with and without CKD. Subgroup analysis was used to compare patients with end-stage renal disease (ESRD) with age- and gender-matched non-CKD individuals. ESRD was defined by CKD patients who need regular renal replacement therapy. The same method was applied to evaluate hazard ratios (HRs). Results: After age and gender matching, there were 11,881 patients in the CKD group and 47,524 in the non-CKD group. After control for possible confounding, the adjusted HR (aHR) of cataract was 1.84 (95% CI 1.73-1.95) for the CKD group. Subgroup analysis of patients with ESRD (n = 3,209) and non-CKD individuals (n = 12,836), with matching done on the basis of age and gender, indicated an aHR of cataract was 2.33 (95% CI 2.10-2.59) for the ESRD group. Conclusions: This study indicates a relationship between CKD and cataract, and suggests that the risk for cataract increases with the severity of renal impairment.

Cataract and systemic disease: A review

“…After accounting for age and gender matching, there were 11 881 patients in the CKD group and 47 524 patients in the non‐CKD group. Their study found the adjusted hazard ratio of cataract was 1.84 in the CKD group and even higher, 2.33, in the end stage renal disease (ESRD) group, suggesting that the risk for cataract increases with the severity of renal function 61 . This is finding was supported by Rim et al who published that patients who began haemodialysis for ESRD were also more likely to undergo cataract surgery and at a younger age 59 …”

Ocular Evaluation in Patients with Chronic Kidney Disease- A Hospital Based Study

“…The paper by Liu et al highlighted the increased prevalence of cataracts in CKD and suggested that cataracts become more common as renal failure worsens but did not conclude whether CKD was important in cataract initiation or progression [2]. Diagnosis of cataract mainly in severe (46.9%) and ESRD (40.6%) groups compared to moderate group showed its association with progression of renal disease [29]. Mean intra ocular pressure in patients of CRF was 13.…”

Chronic Kidney Disease and Cataract: Seeing the Light

“…The paper by Liu et al [3] in this issue of American Journal of Nephrology highlights the increased prevalence of cataracts in CKD, and, for the first time, suggests that cataracts become more common as renal failure worsens. The relationship between CKD and cataract has long been suspected, but it was only recently that it was only recently confirmed.…”

“…The relationship between CKD and cataract has long been suspected, but it was only recently that it was only recently confirmed. The study by Liu et al [3] is a retrospective analysis of data from a public health system; the authors included only individuals who had accessed cataract surgery. Overall, patients with CKD had a 1.84 increased risk (95% CI 1.73-1.95) of cataract after correcting for age, gender, hypertension, socioeconomic status, smoking, and other comorbidities.…”

“…According to Liu et al [3,] we will witness increased incidence of cataracts in CKD patients. The treatment is simple, and improves our patients' quality of life and reduces mortality.…”