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Kidney Week

Abstract: SA-PO1128

Impact of CKD on Incidence of Visual Impairment: The Singapore Epidemiology of Eye Diseases Study

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Sabanayagam, Charumathi, Singapore Eye Research Institute, Singapore, Singapore
  • Chiok, Joanna, Singapore Eye Research Institute, Singapore, Singapore
  • He, Feng, Singapore Eye Research Institute, Singapore, Singapore
  • Lim, Cynthia Ciwei, Singapore General Hospital, Singapore, Singapore
  • Tan, Gavin, Singapore Eye Research Institute, Singapore, Singapore
  • Cheng, Ching-Yu, Singapore Eye Research Institute, Singapore, Singapore

To examine the impact of chronic kidney disease (CKD) on the incidence and severity of visual impairment (VI) in a population-based sample of Asian adults.


We analysed data from 4732 Chinese, Malay and Indian adults who participated in the baseline (2004-2011, aged 40-80 years) and 6-year (2011-2017) follow-up visit of the Singapore Epidemiology of Eye Diseases and were free of VI at baseline. CKD (n=447, 9.4%) was defined as an estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2 and severity of CKD was categorized into stages G1-5. Participants underwent comprehensive eye examinations including refraction and slit-lamp examinations. Incident VI was defined as best-corrected visual acuity (BCVA) <20/40 in the better eye. Severity of VI was defined as normal, low vision and blindness (≥20/40, <20/40 to >20/200 and ≤20/200). Associations between CKD and VI were examined using Logistic regression models adjusted for age, gender, ethnicity, diabetes, and hypertension status.


The incidence of VI was significantly higher in individuals with CKD compared to those without (14.3% vs. 3.3%, p<0.001). In severity analyses, incidence of low vision and blindness were also higher in those with CKD (13.4% and 0.9%) compared to those without (3.3% and 0%, p<0.001). There was a clear trend of increasing incidence of VI with the progression of CKD stages, with rates of 3.3%, 13.5%, and 16.3% in stage G1-2, G3a, and G3b-G5 (p-trend <0.001, Figure 1). After adjusting for other factors, CKD was independently associated with an increased risk of any VI, with an odds ratio of 1.47 (95% confidence interval: 1.03 -2.10).


Our results suggests that the presence of CKD increased the risk and severity of VI in Asian adults. Given the increasing prevalence of CKD worldwide, these findings highlight the importance of regular ocular examinations for individuals with CKD to reduce the risk of VI.

Figure 1: Incidence of VI by baseline CKD stage