Investigators have found a bidirectional relationship between glaucoma and chronic kidney disease (CKD).

Ching-Yu Cheng, MD, MPH, PhD, of Singapore Eye Research Institute and colleagues conducted a systematic review and meta-analysis of 14 observational studies including 1,978,254 adults. Based on an analysis of 10 studies, adults with vs without a CKD at baseline had significant 18% increased odds of developing glaucoma, according to results published in EClinicalMedicine. Based on 4 studies, adults with vs without glaucoma at baseline had significant 3.7-fold increased odds of new-onset CKD. The investigators were only able to assess primary glaucoma, including open-angle and angle-closure glaucoma.

All studies adjusted for age and sex, and a majority adjusted for diabetes and hypertension. East Asian ethnicity was a significant effect moderator, Dr Cheng’s team reported. They explained that Asian populations are predisposed to angle-closure glaucoma due to their eye structure.

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With respect to potential mechanisms linking CKD with glaucoma, the investigators pointed out that diabetes, hypertension, and cardiovascular disease are risk factors for both. Glaucoma and CKD also have common pathogenic pathways, such as microvascular damage and ischemia, endothelial dysfunction, inflammation, oxidative stress, and fluid overload.

“Our findings may provide impetus for the prevention and management of these diseases, such as the recommendation of preventive eye screening for glaucoma in patients with CKD, especially in patients with concomitant diabetes,” Dr Cheng’s team wrote. The investigators recommended that patients receiving routine eye screening for diabetic retinopathy closely adhere to their ophthalmology exam schedules to ensure early detection of glaucoma.

The team could not investigate glaucoma and CKD severity and encouraged further research. They also noted that future studies should assess how treatments for glaucoma and chronic kidney disease affect outcomes in the reciprocal condition.


Yu Ci Ng F, Song H, Tan B, Teo CB, Tsz Yeung Wong E, Yi Boey P, Cheng CY. Bidirectional association between glaucoma and chronic kidney disease: A systematic review and meta-analysis. EClinicalMedicine. Published online June 8, 2022. doi:10.1016/j.eclinm.2022.101498