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2018•The Egyptian Journal of Hospital MedicineOpen access

Abnormal Ocular Findings in Chronic Renal Failure Patients on Hemodialysis

Dina Ezzat Abdel Aziz Mansour, Ahmed M. El-Bayomi, Aml M. El-Azab

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Abstract

Background: chronic kidney disease (CKD) is a global public health problem and diabetes is a leading cause for it. Those patients with end-stage renal disease (ESRD) are generally treated using hemodialysis (HD). HD causes numerous metabolic changes which in turn induce osmotic changes in blood and extracellular fluids including the aqueous and vitreous humor, so there are many ocular abnormalities in ESRD patients either due to common pathophysiological mechanisms and risk factors between eye and kidney diseases or due to hemodialysis itself. Aim of the Work: the aim of this study is to evaluate ocular findings in CKD patients on hemodialysis, including the best-corrected visual acuity (BCVA), measurement of intraocular pressure (IOP), corneal, conjunctival, tear film changes, lens and fundus changes. Patients and Methods: this cross sectional observational study was carried out on twenty three patients (6 males and 17 females) with 44 eyes, with chronic kidney disease on chronic hemodialysis for 2-10 years in the Dialysis Unit at Agouza Specialized Hospital in the period from November 2017 to April 2018. The hemodialysis duration was approximately four hours three times per week. Results: forty three percent of total 44 eyes had BCVA > 6/18. As regard anterior segment, we found yellow sclera was the commonest finding (75%), cataract (61.4%), lid edema (56.8%), dry eye (43.2%), conjunctival congestion (47.7%), and pterygium (13.6%). As regard posterior segment; Diabetic retinopathy was the commonest finding (38.6%), hypertensive retinopathy (4.5%), AMD (2.3%), macular hemorrhage (2.3%). Regarding OCT findings, there was statistically significant difference between eyes of diabetic, hypertensive and other patients as regard central foveal thickness. Conclusion: our results demonstrate high prevalence of abnormal ocular findings in chronic renal failure patients on hemodialysis. So those patients should be evaluated regularly by the ophthalmologist.

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Background: chronic kidney disease (CKD) is a global public health problem and diabetes is a leading cause for it. Those patients with end-stage renal disease (ESRD) are generally treated using hemodialysis (HD). HD causes numerous metabolic changes which in turn induce osmotic changes in blood and extracellular fluids including the aqueous and vitreous humor, so there are many ocular abnormalities in ESRD patients either due to common pathophysiological mechanisms and risk factors between eye and kidney diseases or due to hemodialysis itself. Aim of the Work: the aim of this study is to evaluate ocular findings in CKD patients on hemodialysis, including the best-corrected visual acuity (BCVA), measurement of intraocular pressure (IOP), corneal, conjunctival, tear film changes, lens and fundus changes. Patients and Methods: this cross sectional observational study was carried out on twenty three patients (6 males and 17 females) with 44 eyes, with chronic kidney disease on chronic hemodialysis for 2-10 years in the Dialysis Unit at Agouza Specialized Hospital in the period from November 2017 to April 2018. The hemodialysis duration was approximately four hours three times per week. Results: forty three percent of total 44 eyes had BCVA > 6/18. As regard anterior segment, we found yellow sclera was the commonest finding (75%), cataract (61.4%), lid edema (56.8%), dry eye (43.2%), conjunctival congestion (47.7%), and pterygium (13.6%). As regard posterior segment; Diabetic retinopathy was the commonest finding (38.6%), hypertensive retinopathy (4.5%), AMD (2.3%), macular hemorrhage (2.3%). Regarding OCT findings, there was statistically significant difference between eyes of diabetic, hypertensive and other patients as regard central foveal thickness. Conclusion: our results demonstrate high prevalence of abnormal ocular findings in chronic renal failure patients on hemodialysis. So those patients should be evaluated regularly by the ophthalmologist.

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Available abstract

Background: chronic kidney disease (CKD) is a global public health problem and diabetes is a leading cause for it. Those patients with end-stage renal disease (ESRD) are generally treated using hemodialysis (HD). HD causes numerous metabolic changes which in turn induce osmotic changes in blood and extracellular fluids including the aqueous and vitreous humor, so there are many ocular abnormalities in ESRD patients either due to common pathophysiological mechanisms and risk factors between eye and kidney diseases or due to hemodialysis itself. Aim of the Work: the aim of this study is to evaluate ocular findings in CKD patients on hemodialysis, including the best-corrected visual acuity (BCVA), measurement of intraocular pressure (IOP), corneal, conjunctival, tear film changes, lens and fundus changes. Patients and Methods: this cross sectional observational study was carried out on twenty three patients (6 males and 17 females) with 44 eyes, with chronic kidney disease on chronic hemodialysis for 2-10 years in the Dialysis Unit at Agouza Specialized Hospital in the period from November 2017 to April 2018. The hemodialysis duration was approximately four hours three times per week. Results: forty three percent of total 44 eyes had BCVA > 6/18. As regard anterior segment, we found yellow sclera was the commonest finding (75%), cataract (61.4%), lid edema (56.8%), dry eye (43.2%), conjunctival congestion (47.7%), and pterygium (13.6%). As regard posterior segment; Diabetic retinopathy was the commonest finding (38.6%), hypertensive retinopathy (4.5%), AMD (2.3%), macular hemorrhage (2.3%). Regarding OCT findings, there was statistically significant difference between eyes of diabetic, hypertensive and other patients as regard central foveal thickness. Conclusion: our results demonstrate high prevalence of abnormal ocular findings in chronic renal failure patients on hemodialysis. So those patients should be evaluated regularly by the ophthalmologist.

Key concepts: Medicine, Chronic renal failure, Hemodialysis, Internal medicine, Intensive care medicine

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