ArticleOphthalmology. Glaucoma2026
Increased Risk of Intraocular Pressure-Lowering Treatment in Patients with End-Stage Renal Disease Undergoing Hemodialysis.
Article in Ophthalmology. Glaucoma, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the risk of receiving intraocular pressure (IOP)-lowering treatment in patients with end-stage renal diseases (ESRD) undergoing hemodialysis (HD).
designRetrospective cohort study using electronic health record data obtained from the TriNetX US Collaborative Network.
participantsPatients aged ≥ 20 and ≤ 85 years with a diagnosis of ESRD and HD dependence compared to a healthy control cohort.
methodsIncidence and relative risk for needing IOP-lowering medication or surgery were calculated in the ESRD on HD (ESRD-HD) and control cohorts in an unadjusted analysis. Then, propensity score matching (PSM) was performed to match the cohorts for age and sex (Model 1). Model 2 included Model 1 with additional PSM for systemic comorbidities including diabetes, hypertension, and others. Standardized mean difference (SMD) values were used to assess matching quality. Cumulative incidences and hazard ratios (HR) with 95% confidence intervals (CIs) for IOP-lowering treatment were calculated for glaucoma treatment endpoints at 5 years after the index date.
main outcome measuresRisk of new IOP-lowering treatments including medication and surgery.
resultsThe unadjusted analysis demonstrated that the ESRD-HD cohort had a higher incidence proportion of receiving IOP-lowering medication or surgery (9.57% vs. 4.38%, P < 0.001). After PSM, SMD was <0.1 for all variables, indicating good matching. In Model 1, the ESRD-HD cohort demonstrated statistically significant higher incidence and increased HRs for receiving new IOP-lowering treatment including medication or surgery 5 years after the index date (1.94, 1.81-2.07; HR, 95% CI). In Model 2, the ESRD-HD cohort showed significantly higher HRs for new IOP-lowering treatment including medication or surgery (1.36, 1.26-1.46), medication use (1.38, 1.32-1.44; HR, 95 CI), new medication use (1.36, 1.27-1.46), and new surgeries (1.57, 1.20-2.05), at the 5-year time point. More specifically particularly high HRs in Model 2 were observed for the ESRD-HD cohort needing glaucoma drainage devices (GDDs) (2.09, 1.34-3.25) and cyclodestruction (3.72, 2.10-6.59).
conclusionsThe ESRD-HD cohort was at significantly higher risk of receiving IOP-lowering treatment, ranging from medications to surgery. In particular, the ESRD-HD cohort had a higher risk of undergoing GDD implantation or cyclodestructive procedures, surgical interventions sometimes reserved for patients with more advanced glaucoma. Therefore, patients with ESRD-HD require heightened ophthalmic surveillance to achieve timely intervention. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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