title: The Association of Visual Impairment With Clinical Outcomes in Hemodialysis Patients.
abstract: Visual impairment limits people's ability to perform daily tasks and affects their quality of life. We evaluated the impact of visual impairment on clinical outcomes in hemodialysis (HD) patients.HD patients were selected from the Clinical Research Center registry a prospective cohort study on dialysis patients in Korea. Visual impairment was defined as difficulty in daily life due to decreased visual acuity or blindness. The primary outcome was all-cause mortality and the secondary outcomes were cardiovascular and infection-related hospitalization.A total of 3250 patients were included. Seven hundred thirty (22.5%) of the enrolled patients had visual impairment. The median follow-up period was 30 months. The Kaplan-Meier curve and log-rank test showed that all-cause mortality rates (P < 0.001) as well as cardiovascular and infection-related hospitalization rates (P < 0.001 and P < 0.001) were significantly higher in patients with visual impairment than in patients without visual impairment. In the multivariable analysis, visual impairment had significant predictive power for all-cause mortality (Hazard ratio [HR], 1.77, 95% confidence interval [CI], 1.21-2.61, P = 0.004) and cardiovascular hospitalization (HR 1.45 [1.00-1.90], P = 0.008) after adjusting for confounding variables. Of these 3250 patients, 634 patients from each group were matched by propensity scores. In the propensity score matched analysis, patients with visual impairment had independently significant associations with increased all-cause mortality (HR 1.69 [1.12-2.54], P = 0.01) and cardiovascular hospitalization (HR 1.48 [1.08-2.02], P = 0.01) compared with patients without visual impairment after adjustment for confounding variables.Our data demonstrated that visual impairment was an independent risk factor for clinical adverse outcomes in HD patients.
authors.affiliation: From the Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea (YAH, SYK, YOK, DCJ, HCS, EJC, CWY, YKK); Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea (SHK); Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea (YLK); Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea (YSK); Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea (SWK); Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea (NHK); Cell Death Disease Research Center, The Catholic University of Korea, Seoul, Korea (YKK).
authors.forename: Yu Ah
authors.initials: YA
authors.lastname: Hong
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Su-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Kim
authors.forename: Dong Chan
authors.initials: DC
authors.lastname: Jin
authors.forename: Ho Chul
authors.initials: HC
authors.lastname: Song
authors.forename: Euy Jin
authors.initials: EJ
authors.lastname: Choi
authors.forename: Yong-Lim
authors.initials: YL
authors.lastname: Kim
authors.forename: Yon-Su
authors.initials: YS
authors.lastname: Kim
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Nam-Ho
authors.initials: NH
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007239:Infections / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D006435:Renal Dialysis / Q000401:mortality*; D051437:Renal Insufficiency / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014786:Vision Disorders / Q000150:complications*