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M. E. Nongpiur, C. Sabanayagam, S. M. Saw, T. Y. Wong, T. Aung; Intra-Ocular Pressure and Its Association With Chronic Kidney Disease: The Singapore Malay Eye Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):438.
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To examine the relationship of chronic kidney disease (CKD) with intra-ocular pressure (IOP) in Malay adults in Singapore.
This was a population-based cross-sectional study of 3280 (78.8% response rate) Malay adults aged 40-79 years living in the south-western part of Singapore. Participants underwent a standardized interview, examination and ocular imaging, and laboratory investigations at a centralized study clinic. Goldmann applanation tonometer was used to measure IOP. Blood samples were drawn from all participants to determine levels of serum glucose, glycosylated hemoglobin (HbA1C), lipids (total, HDL and LDL cholesterol), and creatinine. Samples of urine were also collected to determine glomerular filtration rate and levels of microalbuminuria. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or presence of micro/macroalbuminuria defined as urinary albumin-to-creatinine ratio (ACR) ≥17mg/g for men and ≥25mg/g for women.
Complete data was available for 3108 participants. The overall prevalence of CKD was 27.9%. The mean (SD) IOP for all participants was 15.4 (3.7) mmHg. There were 140 persons with glaucoma (4.5%). After adjustments for age and gender, IOP was significantly higher in participants with CKD compared with those without CKD (15.8 mmHg vs. 15.3 mmHg, P<0.0001), and, in the total population, with lower eGFR (15.3, 15.1, 15.6, 15.6 mmHg comparing decreasing eGFR quartiles; P<0.0001) levels. These associations remained significant in separate stratified analyses of persons with and without diabetes, glaucoma or both. In multiple linear regression models adjusting for age, gender, current smoking, alcohol consumption, education, history of cardiovascular disease, hypertension, glaucoma status, BMI, total and HDL cholesterol, persons with CKD had on average, IOP 0.363 mmHg (p=0.02) higher than that of persons without CKD. CKD was not associated with glaucoma.
Our population-based study in Malay adults showed that CKD is associated with higher IOP, independent of age, diabetes and glaucoma status.
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