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Abstract：
Both keratoconus (KCN) and chronic kidney disease (CKD) are multifactorial conditions with multiple aetiologies and share several common pathophysiologies. However, the few studies that have described the relationship between KCN and CKD are limited to case reports and small case series. This study aimed to evaluate the association between KCN and CKD.
The study cohort included 4,609 new-onset keratoconus patients ≥ 12 years identified by the International Classification of Diseases, Ninth Revision, Clinical Modification, code 371.6 and recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The age-, sex-, and comorbidity-matched control group included 27,654 non-KCN patients, selected from the Taiwan Longitudinal Health Insurance Database, 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence and risk of CKD were compared between the two groups. The adjusted hazard ratios (HRs) for CKD were calculated with Cox proportional hazard regression analysis. Kaplan-Meier analysis was used to calculate the cumulative CKD incidence rate.
The incidence rate of CKD was 1.36 times higher in KCN patients than in controls without statistically significant difference (95 % confidence interval [CI] = 0.99-1.86, p = 0.06). In total, 29 male KCN patients and 90 male controls developed CKD during the follow-up period. The incidence rate of CKD was 1.92 times (95 % [CI] = 1.26-2.91; p = 0.002) higher in male KCN patients than in controls. After adjusting for potential confounders, including age, hypertension, hyperlipidaemia, and diabetes mellitus, male KCN patients were 1.75 times (adjusted HR = 1.75, 95 % [CI] = 1.14-2.68, p < 0.05) more likely to develop CKD.
We found that male KCN patients have an increased risk of CKD. Therefore, it is recommended that male KCN patients should be aware of CKD.
The study cohort included 4,609 new-onset keratoconus patients ≥ 12 years identified by the International Classification of Diseases, Ninth Revision, Clinical Modification, code 371.6 and recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The age-, sex-, and comorbidity-matched control group included 27,654 non-KCN patients, selected from the Taiwan Longitudinal Health Insurance Database, 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence and risk of CKD were compared between the two groups. The adjusted hazard ratios (HRs) for CKD were calculated with Cox proportional hazard regression analysis. Kaplan-Meier analysis was used to calculate the cumulative CKD incidence rate.
The incidence rate of CKD was 1.36 times higher in KCN patients than in controls without statistically significant difference (95 % confidence interval [CI] = 0.99-1.86, p = 0.06). In total, 29 male KCN patients and 90 male controls developed CKD during the follow-up period. The incidence rate of CKD was 1.92 times (95 % [CI] = 1.26-2.91; p = 0.002) higher in male KCN patients than in controls. After adjusting for potential confounders, including age, hypertension, hyperlipidaemia, and diabetes mellitus, male KCN patients were 1.75 times (adjusted HR = 1.75, 95 % [CI] = 1.14-2.68, p < 0.05) more likely to develop CKD.
We found that male KCN patients have an increased risk of CKD. Therefore, it is recommended that male KCN patients should be aware of CKD.
摘要：
圆锥角膜（KCN）和慢性肾脏疾病（CKD）都是具有多种病因的多因素疾病，并且具有几种共同的病理生理学。然而,少数描述KCN与CKD之间关系的研究仅限于病例报告和小病例系列.本研究旨在评估KCN与CKD之间的相关性。
研究队列包括4,609例新发病的圆锥角膜患者≥12岁的国际疾病分类，第九次修订,临床改造,代码371.6，2004年至2011年从台湾国民健康保险研究数据库中招募。年龄-，sex-,合并症匹配的对照组包括27,654例非KCN患者，选自台湾纵向健康保险数据库，2000.从索引日期到2013年12月收集并跟踪每位患者的信息。比较两组患者的CKD发生率和发病风险。用Cox比例风险回归分析计算CKD的校正风险比(HRs)。Kaplan-Meier分析用于计算累积CKD发生率。
KCN患者的CKD发生率是对照组的1.36倍，差异无统计学意义（95％置信区间[CI]=0.99-1.86，p=0.06）。总的来说,29名男性KCN患者和90名男性对照在随访期间发生CKD。男性KCN患者的CKD发生率是对照组的1.92倍（95％[CI]=1.26-2.91；p=0.002）。在调整了潜在的混杂因素后，包括年龄,高血压,高脂血症,和糖尿病，男性KCN患者发生CKD的可能性增加1.75倍(校正后HR=1.75,95%[CI]=1.14-2.68,p<0.05)。
我们发现男性KCN患者患CKD的风险增加。因此,建议男性KCN患者应了解CKD.
研究队列包括4,609例新发病的圆锥角膜患者≥12岁的国际疾病分类，第九次修订,临床改造,代码371.6，2004年至2011年从台湾国民健康保险研究数据库中招募。年龄-，sex-,合并症匹配的对照组包括27,654例非KCN患者，选自台湾纵向健康保险数据库，2000.从索引日期到2013年12月收集并跟踪每位患者的信息。比较两组患者的CKD发生率和发病风险。用Cox比例风险回归分析计算CKD的校正风险比(HRs)。Kaplan-Meier分析用于计算累积CKD发生率。
KCN患者的CKD发生率是对照组的1.36倍，差异无统计学意义（95％置信区间[CI]=0.99-1.86，p=0.06）。总的来说,29名男性KCN患者和90名男性对照在随访期间发生CKD。男性KCN患者的CKD发生率是对照组的1.92倍（95％[CI]=1.26-2.91；p=0.002）。在调整了潜在的混杂因素后，包括年龄,高血压,高脂血症,和糖尿病，男性KCN患者发生CKD的可能性增加1.75倍(校正后HR=1.75,95%[CI]=1.14-2.68,p<0.05)。
我们发现男性KCN患者患CKD的风险增加。因此,建议男性KCN患者应了解CKD.
