Eﬀects of hemodialysis on corneal and anterior chamber morphometry and intraocular
            pressure in patients with end-stage renal disease

Çağlayan, Mehtap; Kösekahya, Pınar; Takmaz, Tamer; Altunoğlu, Alpaslan; Ayan, Berna; Atılgan, Cemile Üçgül; Uysal, Betül Seher

doi:10.5935/0004-2749.20170043

Cited by 15 publications

(23 citation statements)

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“…Ocular abnormalities are frequently associated with patients on chronic dialysis, including IOP fluctuation, corneal calcification, retinal hemorrhage, retinal toxicity related to desferrioxamine, anterior ischemic neuropathy, and uremic optic neuropathy [ 24 ]. Among them, the relationship between IOP changes and dialysis has been reported with various results [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 25 ]. Moreover, there has long been a debate regarding whether transient IOP changes during HD would result in the progression of glaucoma [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have discussed intraocular pressure (IOP) changes during HD since the first demonstration of an increase in IOP during dialysis in 1964 [ 5 , 6 ]. Some studies have revealed that IOP may be elevated [ 6 , 7 , 8 , 9 , 10 ], some have shown that IOP does not change [ 11 , 12 ], and some have demonstrated that IOP decreases [ 13 , 14 , 15 , 16 , 17 ]. However, these previous results were either limited by small patient numbers, a short follow-up period, or lack of a comparative group.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Glaucoma in Patients Receiving Hemodialysis and Peritoneal Dialysis: A Nationwide Population-Based Cohort Study

Lim

Lee

Huang

et al. 2020

IJERPH

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This paper investigated the incidence and risk of newly diagnosed glaucoma after the initiation of maintenance dialysis in Taiwan. A case–control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. There were 3949 patients with dialysis in the study group and 78,980 non-dialysis subjects matched by age and sex in the comparison group. The incidence of newly diagnosed glaucoma after the initiation of maintenance dialysis was analyzed based on the diagnostic code for glaucoma. Patients with dialysis had a higher risk of glaucoma (adjusted hazard ratio (aHR): 1.270; 95% confidence interval (CI): 1.035–1.560) than patients without dialysis. The incidence rate of glaucoma was 8.18 per 10,000 person months in the dialysis group, which was higher than that in the non-dialysis group (5.01 per 10,000 person months). Patients with dialysis exhibited a significantly higher risk of angle-closure glaucoma (ACG) (aHR: 1.550; 95% CI: 1.074–2.239). In contrast, there was no significant risk of developing open-angle glaucoma or normal-tension glaucoma in dialysis patients. Our data suggest that dialysis patients are more susceptible to ACG. Regular ophthalmic examinations may be useful in patients with dialysis to identify high-risk individuals with glaucoma, and preventive measures can be applied to avoid permanent vision loss as soon as intraocular pressure (IOP) elevation is identified.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of Glaucoma in Patients Receiving Hemodialysis and Peritoneal Dialysis: A Nationwide Population-Based Cohort Study

Lim

Lee

Huang

et al. 2020

IJERPH

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“…3 Although hemodialysis is the main treatment of end-stage renal failure (ESRD), acute and chronic complications may occur after this treatment. 4 Hypovolemia and increased osmotic pressure after hemodialysis may affect eye tissues with large amounts of blood flow.…”

Section: Introductionmentioning

confidence: 99%

<p>The Effect of Hemodialysis on Axial Length, Ocular Surface, and Intraocular Pressure in Patients with End-Stage Renal Failure</p>

Kalaycı¹,

Hassan²,

Keinan³

et al. 2020

IJGM

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Purpose: To evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), axial length, and ocular surface in patients with end-stage renal failure after singlesession hemodialysis treatment and to examine the correlation of these findings with systemic hemodynamic parameters. Patients and Methods: A total of 112 eyes of 112 patients enrolled in a hemodialysis treatment program for three times a week (approximately four hours per session) for at least three months in our hospital between December 2019 and March 2020 were included in the study. Approximately 30 minutes before and after hemodialysis, the best-corrected visual acuity measurement, slit-lamp examination, IOP measurement, and dilated fundus examination with the Goldmann applanation tonometer were performed in all patients. The axial length measurement was undertaken by ultrasonic biometry, and the CCT measurement by ultrasonic pachymetry. The ocular surface evaluation was performed based on the tear breakup time (BUT), basal secretion time (BST) and keratoepitheliopathy score. Blood pressure, serum osmolarity, and body weight were measured before and after hemodialysis. Results: The mean IOP decreased from 12.2 ± 3.5 to 10.8 ± 2.2 mmHg, and the mean decrease was 1.4 ± 2 mmHg, indicating statistical significance (p<0.001). The mean CCT dropped from 502 ± 41.2 to 494.1 ± 35.4 μm, and the mean decrease was 8.1 ± 7.7 μm, which also indicated a statistically significant change (p<0.001). The mean axial length was reduced from 23.1 ± 0.8 to 22.9 ± 0.8 mm. The reduction in the axial length was significant with an average value of 0.26 ± 0.15 mm (p<0.001). When the ocular surface changes were examined, BUT decreased from 7.4 ± 3.1 to 6.3 ± 2.5 s, BST from 8.6 ± 1.7 to 6.6 ± 1.3 mm, and the keratoepitheliopathy score increased from 0.36 ± 0.61 to 1.59 ± 0.93, and all these changes were statistically significant (p<0.001). There was a significant correlation between the axial length change and the IOP change (r=0.202, p=0.03). A significant correlation was also observed between BST and plasma colloid osmotic pressure (r=−0.268, p=0.004). In addition, there was a strong correlation between serum osmolarity and the keratoepitheliopathy score (r=−0.437, p<0.001). Conclusion: Hemodialysis causes significant changes in IOP, CCT, axial length, and ocular surface. These changes should be considered in the ophthalmological examination of patients after the hemodialysis session.

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“…During chronic hemodialysis (HD), ocular complications such as significant IOP increments, glaucoma, and retro‐ocular pain have been reported in several case studies . Considering that patients treated with chronic HD experience important changes in blood pressure and body fluids volume and composition , several studies have evaluated a potential association between changes in IOP during HD . IOP increments are linked to the incidence of symptoms such as blurred vision, decreased visual acuity, and headache during HD sessions .…”

mentioning

confidence: 99%

“…Several studies of IOP and HD have measured IOP only before HD and after HD, or included one intermediate measure , with contradictory results: some indicate that IOP increases , while others reported a decrease of IOP after HD or no change . The most recent studies showed a decrease of IOP after HD , while other studies report increases during the second HD hour but no change after HD . Additionally, IOP changes have been evaluated during hemofiltration (16) but there are no studies regarding IOP changes during hemodiafiltration (HDF).…”

mentioning

confidence: 99%

Intraocular Pressure Changes During Hemodialysis or Hemodiafiltration in End‐Stage Renal Disease Patients

Saavedra-Fuentes

Pérez-Grovas

Navarrete³

et al. 2018

Ther Apher Dial

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The aim of this study was to evaluate the intraocular pressure during hemodialysis and hemodiafiltration. Fifteen patients were enrolled (seven treated with hemodialysis therapy and eight with hemodiafiltration). The intraocular pressure was measured before and after dialysis and every 30 min during dialysis. Before dialysis, both groups had similar dialysis prescription, blood pressure, and biochemical parameters. At the end of dialysis, potassium, and osmolarity decreased in both groups, while systolic blood pressure and sodium decreased in the hemodialysis group, and glucose decreased in the hemodiafiltration group. Mean intraocular pressure was similar between groups at all measured times and had no significant changes during hemodialysis. During minute 120 of hemodiafiltration, mean intraocular pressure in the left eye decreased significantly compared to minute 90. This suggests a high intra-individual variability of intraocular pressure during both types of dialysis, which could be relevant particularly among those with the risk of glaucoma.

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Eﬀects of hemodialysis on corneal and anterior chamber morphometry and intraocular pressure in patients with end-stage renal disease

Abstract: Uncorrected IOP, corrected IOP, CCT, and CV values decreased after HD, whereas the anterior chamber morphometry values remained similar between the measurements performed before and after HD.

Cited by 15 publications

References 0 publications

Risk of Glaucoma in Patients Receiving Hemodialysis and Peritoneal Dialysis: A Nationwide Population-Based Cohort Study

Risk of Glaucoma in Patients Receiving Hemodialysis and Peritoneal Dialysis: A Nationwide Population-Based Cohort Study

<p>The Effect of Hemodialysis on Axial Length, Ocular Surface, and Intraocular Pressure in Patients with End-Stage Renal Failure</p>

Intraocular Pressure Changes During Hemodialysis or Hemodiafiltration in End‐Stage Renal Disease Patients

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