Renal Impairment and Age-Related Macular Degeneration: A Comprehensive Systematic Review and Meta-Analysis.
Anas Alamoudi, Ahmed Alnabihi, Naif Almufarriji et al.
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In 30 seconds
This systematic review and meta-analysis examined observational and Mendelian randomization evidence on renal impairment and age-related macular degeneration (AMD). Across 19 studies in the primary meta-analysis, chronic kidney disease was associated with higher odds of AMD (OR = 1.27, 95% CI: 1.07-1.50), although heterogeneity was very high (I² = 95.1%). Associations were most consistent for nonexudative AMD and more advanced kidney dysfunction, including dialysis exposure. The findings suggest an eye-kidney association, but the observational evidence and substantial between-study variation do not establish causality or an individual patient’s risk.
Key findings
- CKD was associated with higher odds of AMD: OR = 1.27, 95% CI: 1.07-1.50; I² = 95.1%.
- The association was significant for nonexudative AMD (OR = 1.46, 1.06-1.99), but not statistically significant for early AMD.
- Odds were higher with eGFR <60 mL/min/1.73 m² (OR = 1.40, 1.15-1.72) and dialysis ≥90 days (OR = 1.74, 1.52-2.00).
- Two Mendelian randomization studies supported an association between lower eGFR and AMD (pooled OR = 1.65, 1.54-1.76).
Why it matters
The findings identify a potential link between kidney dysfunction and AMD that may be relevant to risk assessment across both conditions. The apparent gradient with worsening renal measures and the signal for nonexudative disease merit attention, while the very high heterogeneity and limits of causal inference mean the pooled association should not be treated as a precise prediction for an individual.
What to keep in mind
The evidence was largely observational, and pooled estimates had very high heterogeneity (I² = 95.1%). Certainty was low or very low for most subgroups, and causal inference remains uncertain.