Is Kidney Function Associated with Age-Related Macular Degeneration? Findings from the Asian Eye Epidemiology Consortium.

PURPOSE: Chronic kidney disease (CKD) may elevate susceptibility to age-related macular degeneration (AMD) due to shared risk factors, pathogenic mechanisms, and genetic polymorphisms. Given the inconclusive findings in prior studies, we investigated this association using extensive datasets in the Asian Eye Epidemiology Consortium.

DESIGN: Cross-sectional study.

PARTICIPANTS: 51,253 participants from 10 distinct population-based Asian studies.

METHODS: AMD was defined using the Wisconsin Age-Related Maculopathy Grading System, the international Age-related Maculopathy epidemiological study group classification, or the Beckman clinical classification. CKD was defined as estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m2 . A pooled analysis using individual-level participant data was performed to examine the associations between CKD and eGFR with AMD (early and late), adjusting for age, sex, hypertension, diabetes, body mass index, smoking status, total cholesterol and study groups.

MAIN OUTCOME MEASURES: odds ratio (OR) of early and late AMD.

RESULTS: Among 51,253 participants (mean age: 54.1±14.5 years), 5,079 had CKD (9.9%). The prevalence of early AMD was 9.0%, and late AMD was 0.71%. After adjusting for confounders, individuals with CKD were associated with higher odds of late AMD (OR, 1.46; 95% CI, 1.11-1.93; P=0.008). Similarly, poorer kidney function (per 10-unit eGFR decrease) was associated with late AMD (OR, 1.12; 95% CI, 1.05-1.19; P=0.001). Nevertheless, CKD and eGFR were not significantly associated with early AMD (all P ≥0.149).

CONCLUSIONS: Pooled analysis from 10 distinct Asian population-based studies revealed that CKD and compromised kidney function are significantly associated late AMD. This finding further underscores the importance of ocular examinations in CKD patients.