Eye Diseases in Chronic Kidney Disease: A Nationwide Longitudinal Case-control Study in Sweden

Background: Chronic kidney disease (CKD) is a growing health issue that is becoming more prevalent globally, increasing financial cost on healthcare systems. The purpose of this study is to investigate the incidence of eye diseases in patients diagnosed with CKD in Sweden and to evaluate which eye diseases are most likely to develop.

Methods: A longitudinal population-based retrospective case-control study was conducted including all individuals diagnosed with chronic kidney disease during the time period 2001-2019. A total of 19 455 cases and 38 890 controls were included. For each case, two controls were matched with the same sex, age, and county of residence.

Results: CKD patients had a significantly higher risk of contracting any eye disease compared to individuals without kidney disease HR 1.73 (CI 1.67-1.79), with an elevated risk for all blocks of diagnoses except for glaucoma HR 0.95 (CI 0.85-1.06). However, this condition developed earlier in cases than in controls. Subanalyses showed an increased risk for chronic eye disease patients to develop cataract HR 1.70 (CI 1.63-1.78), other retinal disorders HR 1.86 (CI 1.72-2.02), and retinal vascular occlusions HR 2.08 (CI 1.73-2.51). In general, diagnosis of an eye disease occurred earlier in cases than controls.

Conclusions: The results from this study suggest that CKD patients have an increased risk to develop eye disease. Ocular disease seems to develop considerably earlier in CKD, even without staging the severity of the disease, with particularly high risk of developing retinal diseases and cataracts. Screening for eye disease in CKD should be considered.