The Impact Of Chronic Kidney Disease On Cataract Development: A Meta-Analysis

To investigate the risk of developing cataract in patients who were previously diagnosed with chronic kidney disease (CKD).

The meta-analysis was conducted in Departments of Ophthalmology of Jordanian University of Science and Technology & University of Baghdad, College of Medicine.

We searched PubMed, Scopus, Web of Science, Embase and Cochrane databases to conduct meta analysis according to PRISMA guidelines up to 24th December 2024. We extracted and pooled maximally-adjusted effect estimates to account for potential confounders. Analyses were conducted by Reman (v5.4) and R (v4.0.3). Random-effect model was used based on the extent of heterogeneity to pool the odd ratio (OR) and its corresponding 95% Cl. Heterogeneity was quantified using 12 statistics and meta regression was conducted.

10 studies (5 cohorts; 5 cross-sectionals) including 444,457 participants were meta-analyzed. Participants with CKD at baseline had higher pooled odds of cataract (OR=1.50, 95%Cl:1.31-1.72) compared to participants without CKD. The association remained significant in subgroups of diabetic (OR=1.41, 95%Cl:1.26-1.57), hypertensive (OR=1.13, 95%Cl:1.06-1.21), dialysis patients (OR=1.65, 95%Cl:1.20-2.26) and East-Asian studies (OR=1.50, 95%Cl:1.26-1.79). Meta-regression identified diabetes prevalence as a significant predictor for cataract (β = 0.153, SE = 0.0309, Z =4.952, p < 0.0001). Further, diabetes explained 100% of heterogeneity (R² = 1.0), with 0% residual heterogeneity (I² = 0%), implying high consistency of the effect across studies.

Our results suggest that CKD patients have an increased risk to develop cataract, particularly among diabetic population. Therefore, CKD patients and their primary physicians should be aware of this association which can provide a clue for further screening of those patients.