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Ruchi Singhal, Valentina Reffatto, Akshaya K Gupta, Marjan Afrouzian, Praveena Gupta; The association between CKD and dry AMD in hypertensive patients: a retrospective observational study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2999.
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The retinal-renal association can be attributed to the retina and the kidney sharing similar structure and function. However, limited studies have associated chronic kidney disease (CKD) with dry age-related macular degeneration (dry AMD). This retrospective study investigates the role of hypertension in the risk to develop dry age-related macular degeneration in chronic kidney disease patients.
We analyzed demographics and blood biomarkers in 8,837 subjects seen at University of Texas Medical Branch between 2011-2018 on an island-based population in south Texas, Galveston. Demographics were collected from patients with a diagnosis of either dry AMD or CKD, patients with both conditions, and from a control population. Subjects were stratified by hypertension (HT) status, and differences were assessed. The odds of developing dry AMD in CKD patients was modeled by logistic regression using SAS (Analytics Software & Solutions) alpha=.05. Patients with diabetes and wet AMD were excluded from study.
Chart analysis identified 482 patients with dry AMD, 792 patients with CKD and 84 with both diseases. Hypertension was prevalent in 91.66% in dry AMD and CKD group, 66.5% in dry AMD, 90.6% in CKD and 54.6% in control. Serum albumin was significantly lower in dry AMD, CKD, both AMD and CKD vs. control (p<.001) in hypertensive patients. Blood urea nitrogen was significantly higher in CKD and combined CKD and AMD cohort with or without hypertension. Creatinine and BUN did not affect dry AMD group. Glomerular filtration rate (eGFR) was lower in CKD and combined CKD dry AMD patients as expected, however was not significant in dry AMD groups when compared to control (p=1.00). In hypertensive patients, proteinuria was noted in all 3 cohorts and was significantly different than control (p<.001). Notably, a lower systemic diastolic blood pressure was noted significantly in dry AMD, CKD and combined group than control (P>.001). Significant association between dry AMD and CKD was noted in Hispanics after adjusting for age, sex and HT with odds of AMD 2.4 times with CKD (p=.011).
Hypertension is a modifiable risk factor for dry AMD and CKD, thus should be tightly controlled to reduce the burden of CKD and dry AMD in patients. Hispanic CKD patients are at higher risk for dry macular degeneration and should be screened yearly for early detection of dry AMD.
This is a 2020 ARVO Annual Meeting abstract.
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