Chronic kidney disease and intraocular pressure: the Singapore Malay Eye Study.
OBJECTIVE
To examine the relationship of chronic kidney disease (CKD) with intraocular pressure (IOP) and glaucoma in Malay adults in Singapore.


METHODS
Population-based, cross-sectional study.


METHODS
We included 3280 (78.8% response rate) Malay adults aged 40 to 79 years living in Singapore.


METHODS
Participants underwent a standardized interview, ocular examination, imaging, and laboratory investigations. Goldmann applanation tonometry was used to measure IOP. Glaucoma was diagnosed using the International Society of Geographic and Epidemiological Ophthalmology classification. Non-fasting serum glucose, glycosylated hemoglobin, and creatinine were obtained from all participants. Estimated glomerular filtration rate (eGFR) and microalbuminuria were also determined. We defined CKD as eGFR < 60 ml/min/1.73 m(2) or presence of micro/macroalbuminuria, defined as urinary albumin-to-creatinine ratio > or =17 mg/g for men and > or =25 mg/g for women.


METHODS
We assessed CKD, IOP, and glaucoma.


RESULTS
The overall prevalence of CKD was 27.92% and glaucoma 4.5%. The mean (standard deviation [SD]) IOP was 15.41 (3.7) mmHg. After adjustments for age and gender, IOP was significantly higher in participants with CKD compared with those without CKD (15.8 vs 15.3 mmHg; P<0.0001). The IOP was also higher with lower levels of eGFR (P<0.001). These associations remained significant in separate stratified analyses of persons with and without diabetes, glaucoma, or both. In multiple linear regression models, persons with CKD had on average IOP that was 0.305 mmHg higher than that of persons without CKD. No association between CKD and glaucoma (age and gender adjusted odds ratio [OR], 0.82; 95% confidence interval [CI], 0.56-1.20; and multivariate adjusted OR, 0.87; 95% CI, 0.58-1.29) was found.


CONCLUSIONS
Our population-based study in Malay adults showed that CKD is associated with higher IOP, independent of age, diabetes, and glaucoma status.
Nongpiur
Monisha E
ME
Singapore Eye Research Institute & Singapore National Eye Center, Singapore.
Wong
Tien Y
TY
Sabanayagam
Charumathi
C
Lim
Su-Chi
SC
Tai
E-Shyong
ES
Aung
Tin
T
D000328:Adult; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D001824:Body Constitution; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000453:epidemiology / Q000503:physiopathology*; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012846:Singapore / Q000453:epidemiology; D014065:Tonometry, Ocular
D001786:Blood Glucose; D003404:Creatinine; D006442:Glycated Hemoglobin