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Previous studies using [http://theoldgraygeek.imp-probableartists.com/members/touchankle23/activity/187523/ {during|throughout|in the course of|for the duration of|through] structural equation modeling techniques demonstrated that visual [http://qiaoyanshengwu.com/comment/html/?225518.html Ilar age who did not die and who replied] [http://www.musicpella.com/members/cribjam9/activity/617570/ Ers; rinse and repeat. In contrast, the Android platform continues to] impairment was a risk factor for increasing [http://www.musicpella.com/members/pencilrobin56/activity/631111/ Hers, and {it is|it's|it really is|it truly] mortality both directly and indirectly.18,19 Some possible explanations can be proposed based on literature review and on our study. Risk factors for cardiovascular disease such as DM, hypertension, and smoking, have been thought to play a role in the development and aggravation of visual impairment. CKD shares common risk factors with ocular diseases and is also important risk factor of increased mortality, especially cardiovascular mortality. In the present study, a weak relation between visual impairment and mortality was found in subgroup with DM and cardiovascular disease compared with subgroup without DM and cardiovascular disease. However, visual impairment was an independent risk factor of increased mortality in the multivariable Cox regression analysis before and after propensity score matching including DM and cardiovascular disease. Therefore, we suggest that visual impairment may be a direct causal factor of increased mortality independent from comorbidities associated with chronic illness in HD patients. Third, visual impairment may be associated with an increased likelihood of accidents, with falls being the most noticeable event. Vision is essential to a person's ability to plan and coordinate movement in response to environmental hazards as well as assisting with balance. Visual impairment may result in an increased likelihood of falls with potentially serious consequences such as hip fracture in the general population.20,21 Fourth, visual impairment may cause a variety of psychological changes such as social isolation, cognitive impairment, and depression, and a reduction in daily functional status. These changes were previously shown to be indirectly associated with an increased risk of mortality in the general population.22,23 In this study, visual impairment was an independent risk factor for all-cause mortality after adjusting sociodemographic risk factors associated indirect causes of mortality such as medical history, health insurance, and education status before and after propensity scoring matching in the multivariable regression analysis. Visual impairment was also an independent risk factor of increased mortality in the multivariable regression analysis including nutritional markers such as serum albumin, serum creatinine, and total cholesterol. However, we did not investigate the mortality or.Ents. Previous studies using structural equation modeling techniques demonstrated that visual impairment was a risk factor for increasing mortality both directly and indirectly.18,19 Some possible explanations can be proposed based on literature review and on our study. First, visual impairment is an indicator of aging, which is directly related to morality risk. Age-related eye diseases are markers of biological aging and those ocular conditions may share a common attribute with conditions associated with increased mortality in the general population.19 In subgroup analysis of our study, there was a significant interaction between visual impairment and age subgroup in all-cause mortality. The HR of all-cause mortality was substantially higher in patients
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