Risk of Retinal Vein Occlusion Following End-Stage Renal Disease

Abstract

The aim of the study was to investigate the risk of retinal vein occlusion (RVO) following end-stage renal disease (ESRD). The study was designed as a retrospective, nationwide, matched cohort study. The subjects were ESRD patients identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 585. The study cohort included 92,774 ESRD patients registered between January 2000 and December 2009 at the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 92,774 patients (case:control = 1:1) selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. The incidence and risk of RVO were compared between the ESRD and control groups. The adjusted hazard ratio (HR) for RVO after adjustment for potential confounders was obtained by Cox proportional hazard regression analysis. Kaplan–Meier analysis was used to calculate the RVO cumulative incidence rate. The main outcome measure was the incidence of RVO following ESRD.In total, 904 ESRD patients (0.97%) and 410 controls (0.44%) had RVO (P < 0.0001) during the follow-up period, leading to a significantly elevated risk of RVO in the ESRD patients compared with controls (incidence rate ratio = 3.05, 95% confidence interval = 2.72–3.43). After adjustment for potential confounders including diabetes mellitus, hypertension, hyperlipidemia, congestive heart failure, and coronary artery disease, ESRD patients were 3.05 times more likely to develop RVO in the full cohort (adjusted hazard ratio = 3.05, 95% confidence interval = 2.64–3.51). In addition, hypertension patients showed high incidence rate of RVO in the ESRD group compared with controls (incidence rate ratio = 1.71, 95% confidence interval = 1.44–2.03) and maintained significant risk of RVO after adjustment for other confounders in the cohort (adjusted hazard ratio = 1.39, 95% confidence interval = 1.20–1.60).ESRD increases the risk of RVO. For ESRD patients, we recommend education regarding RVO in addition to blood pressure control to prevent subsequent RVO.

Risk of Retinal Vein Occlusion in Patients With End-Stage Renal Disease: A 12-Year, Retrospective, Nationwide Cohort Study in South Korea

“…Our study has the longest follow-up period (mean, 7.37 years) and, to the best of our knowledge, is the first to examine the association between ESRD and RVO using an extensive database in South Korea. Chen et al 18 and Chang et al 19 reported the adjusted HR for RVO development in ESRD patients as 1.50 (95% CI, 1.13-1.99; P ¼ 0.0056) and 3.05 (95% CI, 2.64-3.51; P < 0.05),…”

“…To the best of our knowledge, only in Taiwan were there longitudinal epidemiologic studies with extensive data evaluating the association between ESRD and RVO. 18,19 As an epidemiologic study, confirming reproducibility is a crucial aspect. In addition, South Korea and Taiwan are the only countries in East Asia in which a nationwide cohort database is established for the entire nation.…”

“…11,13,48,49 One study even reported DM to be a protective factor. 19 The association between DM and RVO could be weak, but considering that diabetes is the cause of many cardiovascular diseases, more research is necessary to clarify this. Because of the high level of global medical care, many patients with diabetes have been referred for ophthalmologic screening by the internal medicine department and are undergoing early treatment before the development of a serious retinal vascular abnormality.…”

“…16,17 Therefore, ESRD also can be considered a risk factor for RVO; however, few studies have evaluated the association between ESRD and RVO development on the basis of extensive data. 18,19 The aim of the present study was to evaluate the risk of RVO in Korean patients with ESRD.…”

Cataract surgery-related complications in patients with end-stage renal disease- a nationwide population-based study in Taiwan

“…This correlation may have arisen because the same microvascular damage process causes both retinopathy and nephropathy. Besides, the higher rate of retinal vein occlusion and age-related macular degeneration in ESRD patients may also contribute to the increased risk of VH after cataract surgery 20,21 .…”