Association between Dry Age-Related Macular Degeneration, Chronic Kidney Disease and Hypertension: a Retrospective Chart Review Study

Background: Chronic kidney disease (CKD) and age-related macular degeneration (AMD) are two global health concerns that cause significant disability in the elderly. These two diseases share common risk factors and pathological mechanisms. This study investigates the association between hypertension (HTN), CKD and dry AMD in a diverse racial population. Methods: Data from 8,837 participants aged 40-100 years was retrieved for this retrospective chart review study. Subjects were identified for HTN, CKD and dry AMD, using ICD-10 codes, from the database of University of Texas Medical Branch, Galveston. Patient demographics and their metabolic panels pertaining to kidney and HTN were collected. Logistic regression models were performed to study the association between HTN, CKD and dry AMD after adjusting for age, gender, race and smoking habits. Results: The logistic regression model for the prevalence of dry AMD with HTN and CKD, excluding an interaction, but without adjustment for demographics (age, gender, race and smoking) suggest positive significant association between HTN and CKD. The coefficients of the model suggest that the odds of dry AMD is 1.4 folds higher for patients with CKD (p=007), and 1.6 folds higher in patients with HTN (p<0001). However, this relationship loses its significance after adjusting for demographic variables suggesting that the effect of CKD and HTN on dry AMD is mediated by age, gender and race. Logistic regression model stratified by race, relating prevalence of dry AMD to the presence of CKD after controlling for effects due to age, gender and HTN show no association of race with HTN. A significant association between dry AMD and CKD in the Hispanic population was noted; with odds of dry AMD being 2.4 folds higher than those without (OR 2.35, 95% 1.21-4.57; p=0.01). Conclusion: Hypertension is a common risk factor for both dry AMD and CKD and therefore should be controlled at the primary care level so as to reduce the burden of concomitant diseases. Dry AMD is associated with CKD in Hispanic population, needs further studies. Nonetheless, yearly fundoscopic examination should be recommended for patients with HTN and CKD for early detection of dry AMD.