title: Risk of Retinal Artery Occlusion in Patients With End-Stage Renal Disease: A Retrospective Large-Scale Cohort Study.
abstract: There is globally increasing prevalence and incidence in end-stage renal disease (ESRD). These patients are frequently reported to have retinal abnormalities and both diseases share some systemic risk factors. Hence, it is clinically relevant to determine whether ESRD is a predictor of retinal artery occlusion (RAO).To investigate the risk of RAO in ESRD patients.A retrospective, nationwide, matched cohort study. The study included 93,766 ESRD patients recruited between 2000 and 2009 from the Taiwan National Health Insurance Research Database. The same number control group included age- and sex-matched patients without ESRD selected from the Taiwan Longitudinal Health Insurance Database, 2000. Data for each patient were collected from the index date until December 2011.The incidence and risk of RAO were compared between the 2 groups. The hazard ratio (HR) for RAO after adjustment for potential confounders was calculated using Cox proportional hazards regression. Kaplan-Meier analysis was used to calculate the cumulative RAO incidence rate.In total, 237 ESRD patients and 73 controls exhibited RAO during follow-up; thus, the RAO incidence rate in ESRD patients was 4.49 times (95% confidence interval (CI), 3.45-5.83) that in the control patients. After adjustment for potential confounders, including diabetes mellitus, hypertension, hyperlipidemia, congestive heart failure, and coronary artery disease, ESRD patients were 2.78 times (95% CI, 2.02-3.84) more likely to develop RAO in cohort for the total sample. Among patients with hypertension, the RAO incidence rate was significantly higher in the ESRD group, and hypertension significantly increased RAO risk even after adjustment for other confounders in the cohort.ESRD increases the risk of RAO, particularly in ESRD patients with hypertension. Therefore, clinicians should educate ESRD patients about RAO and ensure appropriate blood pressure control.
authors.affiliation: From the Department of Ophthalmology (Y-SC, S-HT), Department of Medical Research (S-FW, J-JW), Department of Anesthesiology (J-JW), Department of Occupational Medicine, Chi Mei Medical Center (S-BS, C-CH), Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University (Y-SC, S-YK), Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University (S-HT), Graduate Institute of Clinical Medicine, National Cheng Kung University (J-YW, R-LJ), Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology (S-BS), Department of Child Care and Education, Southern Taiwan University of Science and Technology (C-CH), Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan (R-LJ), Department of Education, University of Taipei, Taipei (CC), and Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan (S-FW).
authors.forename: Yuh-Shin
authors.initials: YS
authors.lastname: Chang
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.forename: Chun
authors.initials: C
authors.lastname: Chang
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Sung-Huei
authors.initials: SH
authors.lastname: Tseng
authors.forename: Shun-Yao
authors.initials: SY
authors.lastname: Ko
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Jiu-Yao
authors.initials: JY
authors.lastname: Wang
authors.forename: Ren-Long
authors.initials: RL
authors.lastname: Jan
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015356:Retinal Artery Occlusion / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment