Research Paper Volume 14, Issue 12 pp 5116—5130
Risk of dialysis in patients receiving intravitreal anti–vascular endothelial growth factor treatment: a population-based cohort study
- 1 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- 2 Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- 3 Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 4 Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 5 Department of Laboratory Science and Technology, Kaohsiung Medical University, Kaohsiung, Taiwan
- 6 Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Received: March 9, 2022 Accepted: June 14, 2022 Published: June 20, 2022https://doi.org/10.18632/aging.204133
How to Cite
Copyright: © 2022 Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We utilized the Longitudinal Health Insurance Database which was stemmed from the Taiwan's National Health Insurance Research Database to conduct a retrospective cohort study investigating the risk of becoming dialysis dependent after receiving intravitreal anti-vascular endothelial growth factor (VEGF) agents for retinal diseases. Patients newly receiving intravitreal ranibizumab or aflibercept from 2000 to 2017 for age-related macular degeneration, polypoidal choroidal vasculopathy, diabetic macular edema, retinal vein occlusions, or myopic choroid neovascularization were included as the study group, and patients with same retinal diseases but did not receive intravitreal anti-VEGFs served as controls extracted by age- and sex-matched (1:4) and further propensity score matching (PSM). Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the risk of dialysis. A cohort of 2447 anti-VEGF users and 2447 controls by PSM were evaluated. Higher dialysis risks were observed among patients newly receiving anti-VEGF agents compared to controls (adjusted HR: 1.849; 95% CI: 1.378–2.482) in the PSM cohort. For subgroup analysis, patients newly receiving anti-VEGF treatment for diabetic macular edema had significant risk (adjusted HR: 1.834; 95% CI: 1.448–2.324) of becoming dialysis-dependent, while patients in other subgroups demonstrated similar risks as the controls. In conclusion, intravitreal anti-VEGF agents might increase the risk of becoming dialysis-dependent, especially in patients who are treated for diabetic macular edema.