Risk of Retinal Artery Occlusion in Patients With End-Stage Renal Disease

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.

Chemical Composition of Three Nitraria Species Fruits

“…The total sugar contents of Nitraria species were found to be lower as compared to Nitraria of Qinghai origin (6.81-7.06 %). A higher total fat range (3.86-4.12 %) was reported previously [32]. The overall results showed that the fruit could be a potential source of sugar, flavonoid and total fat.…”

Risk of retinal artery occlusion in patients with diabetes mellitus: A retrospective large-scale cohort study

“…Some studies have reported that several comorbidities, such as hypertension, hyperlipidaemia, congestive heart failure, coronary artery disease, and chronic renal failure, are associated with RAO, a vision-threatening retinal vascular disease [ 12 , 42 – 44 ]. In this cohort study, we evaluated these comorbidities in patients with DM and found that hypertension was the only significant risk factor for RAO in both groups.…”

Risk of serous retinal detachment in patients with end-stage renal disease on dialysis

“…The study has high statistical power and increased precision in risk appraisal because it is based on a nationwide population-based dataset, including a large sample of patients with ESRD on dialysis. Several previous studies using the same database have already been published [ 9 , 32 , 33 ]. Furthermore, our study is a cohort study analysing the incidence of serous retinal detachment in patients with ESRD on dialysis, with comparisons between cohorts over a 10-year period.…”

“…Taiwan has the highest incidence and prevalence of patients with ESRD on dialysis [ 6 – 8 ]. Furthermore, the association between ESRD and many retinal diseases, such as retinal artery occlusion, retinal vein occlusion, or age-related macular degeneration, has been demonstrated by several reports recently [ 9 – 11 ].…”