A bidirectional association between chronic kidney disease (CKD) and glaucoma demonstrates how crucial it is for the entire physiology of the body to work in tandem to ensure good health, according to investigators from the Yong Loo Lin School of Medicine at the National University of Singapore.
The team discovered patients with baseline CKD have an 18% higher risk of incident glaucoma, with the risk increasing to 42% in patients with CKD due to diabetes. The association was more prevalent among patients of East Asian ethnicity. Conversely, patients with glaucoma have more than 3.6 times higher risk of incident CKD after 10–15 years of follow-up.
Published in eClinicalMedicine1 in June 2022, they hypothesised that the association may be due to the two diseases sharing common risk factors, such as diabetes, hypertension, and cardiovascular disease; common disease processes such as renin-angiotensin system (RAS) dysfunction – in which a hormonal system is unable to regulate blood pressure, fluid, and electrolyte balance; other functions in the body. Other disease processes include oxidative stress, and inflammation. Causal mechanisms may also play a role in the presence of both diseases, as CKD results in fluid overload and accumulation of toxic metabolites, disturbing the osmotic pressure in the eye, and at the same time accelerating arteriosclerosis.
While more research is required to conclude a cause-and-effect relationship between CKD and glaucoma, the investigators highlighted the complex interplay of factors between disease states. They also emphasised the importance of reducing risk factors such as diabetes and hypertension that are implicated in multiple health problems.
Reference
- Faye Yu Ci Ng, Benjamin Kye Jyn Tan, Harris Jun Jie Muhammad Danial Song, Chong Boon Tan, Chong Boon Teo, Emmett Tsc Yeung Wong, Pui Yi Boey, et al. Bidirectional association between glaucoma and chronic kidney disease: A systematic review and meta-analysis. eClinicalMedicine, published June, 2022; doi: 10.1016/j.eclinm.2022.101498
