J Korean Med Sci.  2021 Aug;36(30):e201. 10.3346/jkms.2021.36.e201.

The Nationwide Incidence of Retinal Vein Occlusion Following Dialysis due to End-stage Renal Disease in Korea, 2004 through 2013

• Moon TH
• Han JH
• Kang M
• Kim JS
• Kim JY
• Chae JB
• Kwon SK
• Kang G
• Kim DY

• KMID: 2519196
• DOI: http://doi.org/10.3346/jkms.2021.36.e201

Abstract

Background
We investigated the incidence and risk of retinal vein occlusion (RVO) in endstage renal disease (ESRD) patients on dialysis in Korea.
Methods
In this nationwide cohort study, we used Korean National Health Insurance Service data between 2004 and 2013 for analysis. ESRD patients who started dialysis from 2004 to 2013 and an equal number of controls were selected through propensity score matching. RVO incidence in both cohorts were calculated for 2004–2013 using washout data from 2003. The multivariable Cox proportional hazards model was used to assess the risk of RVO in dialysis cohort. The Kaplan-Meier method was used to generate the cumulative RVO incidence curve. Whether the dialysis modality affects the development of RVO was also evaluated.
Results
In this study, 74,551 ESRD patients on dialysis and the same number of controls were included. The incidence of RVO was significantly higher in the dialysis cohort than in the control cohort (dialysis = 7.3/1,000 person-years [PY]; control = 1.9/1,000 PY; P < 0.001). The cumulative-incidence of RVO was also significantly higher in the dialysis cohort than in the control cohort (P < 0.001; log-rank test). However, there was no significant difference in the incidence of RVO between the two dialysis methods (P = 0.550; log-rank test).
Conclusion
This study provided epidemiological evidence that receiving dialysis for ESRD could increase the risk of developing RVO. We also found a rapid increase in the incidence of RVO with a longer dialysis period. These results strengthen the relationship between retinal vascular disease and renal function.

Keyword

Dialysis; End-Stage Renal Disease; Incidence; Korea; Retinal Vein Occlusion

Figure

• 

  Fig. 1 Patient and control enrollment flow chart, showing selection from database. We selected 74,551 end-stage renal disease patients for the dialysis cohort and a corresponding number of individuals for the control cohort, after excluding ineligible subjects.RVO = retinal vein occlusion.

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  Fig. 2 Kaplan-Meier curve of the cumulative-incidence of RVO in end-stage renal disease patients undergoing dialysis and controls, during the follow-up period. The cumulative-incidence of RVO was significantly higher in the dialysis cohort than in the control cohort (P < 0.001; log-rank test), and the cumulative-incidence of RVO in the dialysis cohort increased rapidly after 8 years of follow-up.RVO = retinal vein occlusion.

• 

  Fig. 3 Kaplan-Meier curve of cumulative-incidence of RVO in end-stage renal disease patients undergoing dialysis and controls, during the follow-up period, according to the type of dialysis. Both hemodialysis and peritoneal dialysis subgroups showed a higher cumulative-incidence of RVO than the control cohort (both P < 0.001; log-rank test). Regardless of the method of dialysis, the incidence of RVO rapidly increased with an increase in the duration of dialysis.RVO = retinal vein occlusion.

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