Risk of Meniere’s disease among patients with chronic kidney disease: a nationwide cohort study in Taiwan
|關鍵字:||聽力損失;慢性腎臟病;梅尼爾氏症;腎臟;腎臟;透析;尿毒症;眩暈;內耳;耳鳴;淋巴;Hearing loss;chronic kidney disease;Meniere’s disease;Renal;Kidney;Hemodialysis;Uremic;Vertigo;Inner ear;Tinnitus;Endolymphatic|
研究結果：本研究發現有慢性腎臟病的人與沒有慢性腎臟病的病人在經過三年後的追蹤，罹患梅尼爾氏症的比例分別為0.27%與0.16%且統計上具有顯著差異(p < 0.001)。將潛在的危險因子經過校正後，結果顯示有慢性腎臟病的病患在經過三年追蹤後得梅尼爾氏症的風險相較於對照組有1.58倍之高(95 % CI = 1.24 – 2.02 )且達統計上顯著差異(p < 0.001)。在本研究中發現性別、年紀、自體免疫疾病中的皮肌炎、類風濕性關節炎、乾燥綜合症以及糖尿病亦為梅尼爾氏症的獨立風險因子。
Purpose：Chronic kidney disease (CKD) is the ten leading causes of death in Taiwan. In many countries, the incidence has increased year by year. The incidence of kidney disease in Taiwan has about 11.9% and the mortality rate as high as 80%, people who had CKD indirectly affecting the health, the economy and a lot of resource of health insurance. As we know, CKD have many complications such as hypertension, cardiovascular disease, renal anemia, renal bone disease, neuropathy, infection etc. In order to reduce the health insurance waste of medical resources and achieve the goal of preventing early in the field of prevention medicine, directing against the risk factor of CKD to prevent. Furthermore, how to prevent the consequential diseases of CKD is also important. According previous studies revealed, the kidneys and the inner ear have been existed many related. However, there has no formally study to investigate the relationship between CKD and Meniere’s disease. Therefore, when we clarified the CKD patients have a high risk to develop Meniere’s disease, we not only treated the CKD but also prevented the risk of Meniere’s disease at the same time. Method：This is a longitudinal study and used 2000-2010 data from the National Health Insurance Research Database. First, we collected the patients who had over 20 years old and had first diagnosed with CKD in 2003-2007 as our study cohort. Then, our control cohort was randomly selected three age- and gender-matched subjects without CKD. After that, for each individual we follow up for three years form the index date to identify those who subsequently developed Meniere’s disease. Finally, the chi-square test, Kaplan-meier, cox proportional hazard model and log-rank test were used to analyze the data. Results：In this study, we compared CKD cohort to control cohort, we found patients with CKD had a higher proportion developed into Meniere’s disease (0.27% vs. 0.16%) and both them had a statistically significant difference (p <0.001). After adjusting for potential confounders, the results showed the hazard ratio of Meniere’s disease during the 3-year follow-up period was 1.58 higher for patients with CKD (95% CI = 1.24 – 2.02, p < 0.01) compared with the control cohort. In addition, this study also found gender, age, dermatomyositis, rheumatoid arthritis and Sjo¨gren syndrome of autoimmune diseases and diabetes was also an independent risk factor of getting Meniere’s disease. Conclusion：Our analysis presents that has a significant associated between CKD and increased risk of developing Meniere’s disease. Comorbidities of dermatomyositis, rheumatoid arthritis, Sjo¨gren syndrome and diabetes in patients with CKD displayed to be associated with increased risk of suffering Meniere’s disease, especially for the patients who are female and 40 years of age and older.