Bidirectional Association Found Between Glaucoma, CKD

Higher odds of incident glaucoma were seen in patients who had chronic kidney disease (CKD) compared with participants without, according to a review published in eClinicalMedicine.

The researchers used the PubMed, Embase, and Cochrane Library databases from their inception until June 15, 2021, to look for studies for this review. There were 14 articles covering 15 studies included in the review; 10 of the articles analyzed glaucoma with CKD exposure as the outcome and the remaining 4 analyzed CKD with glaucoma exposure. The studies covered 1,978,254 participants. The mean age of the participants ranged from 45 to 73 years.

Participants with CKD demonstrated a significantly higher odds ratio of glaucoma (odds ratio [OR], 1.18; 95% CI, 1.04-1.33) compared with participants without CKD. The association was also found in longitudinal studies (OR, 1.33; 95% CI, 1.11-1.60) but not in cross-sectional studies (OR, 1.13; 95% CI, 0.98-1.31).

Participants with diabetes (OR, 1.42; 95% CI, 1.26-1.60), who had primary open angle glaucoma (OR, 1.22; 95% CI, 1.03-1.44), and were of East Asian descent (OR, 1.35; 95% CI, 1.25-1.46) had a significant association between glaucoma and CKD.

The associations in patients with primary close angle glaucoma, without diabetes, and of non-East Asian descent were not significant.

There were some limitations to this study. The type of glaucoma was not specified in all of the studies used, which meant that only the association between primary glaucoma and CKD could be evaluated. Further, cataract surgery or vitrectomy were not mentioned in any studies, which may have affected the results, and the review primarily used cross-sectional studies which are not capable of fully explaining the relationship between CKD and glaucoma.

The researchers concluded that the multi-adjusted systematic review demonstrated that participants with CKD had 18% higher pooled odds of incident glaucoma compared with participants without CKD, particularly in populations with diabetes, primary open-angle glaucoma, and of East Asian descent.

“It is worthwhile for physicians to be aware of this potential relationship in the holistic care of their patients. This could provide impetus for the prevention and management of these diseases, reducing their burden on public health and obviating their debilitating impact on quality of life,” they concluded.

Reference

Ng FYC, Song HJJMD, Tan BKJ, et al. Bidirectional association between glaucoma and chronic kidney disease: a systematic review and meta-analysis. eClinicalMedicine. Published online June 8, 2022. doi:10.1016/j.eclinm.2022.101498