Abstract
BackgroundTo explore ocular changes during hemodialysis (HD) in chronic renal failure patients and to determine the effects of different causes of renal failure during HD.MethodsA total of 90 eyes from 45 end-stage renal disease (ESRD) patients undergoing HD were evaluated in this study. All ophthalmological examinations were conducted within 1 h before and after a single HD session. The HD patients were divided into primary kidney disease (KD), hypertensive KD, diabetic KD (DM-KD) and unknown etiology subgroups according to the primary etiology of renal failure. The statistics of 38 eyes from 19 healthy people were set as normal control.ResultsTear break-up time (TBUT) (P = 0.020), Schirmer’s I test results (P = 0.030), anterior chamber depth (ACD) (P = 0.006), lens thickness (LT) (P < 0.001) and choroidal thickness (CHT) (P < 0.001)decreased significantly after a single HD. The retinal nerve fiber layer (RNFL) thickness and average retinal thickness (RT) increased after HD, especially in the nasal inner macula (NIM) subfield (P < 0.001), the inferior inner macula (IIM) subfield (P = 0.004) and the superior outer macula (SOM) subfield (P = 0.012). TBUT, Schirmer’s I test, IOP, RT, and CHT were correlated with one or more parameters. All ESRD patients regardless of etiology had the same trend for most parameters during HD, with the exception of the logMAR of BCVA, central corneal thickness, RNFL thickness and CHT.ConclusionsHD may affect a range of ocular parameters in ESRD patients. Dry eye parameters, RT and CHT exhibited the most obvious changes. Different etiologies tended to have similar trends in ocular parameter changes during HD.
Highlights
To explore ocular changes during hemodialysis (HD) in chronic renal failure patients and to determine the effects of different causes of renal failure during HD
The hemodialysis group was divided into primary kidney disease (KD), hypertensive KD and diabetic KD (DM-KD) subgroups strictly according to the initial etiology of renal insufficiency
Demographic characteristics of the HD patients and healthy controls A total of 90 eyes from both sides of 45 HD patients were included in the study, including 27 pairs of male eyes (60.00%) and 18 pairs of female eyes (40.00%)
Summary
To explore ocular changes during hemodialysis (HD) in chronic renal failure patients and to determine the effects of different causes of renal failure during HD. End-stage renal disease (ESRD), with a glomerular filtration rate lower than 15 ml/ (min*1.73 m2), is the 5th stage of disease and the final outcome of disease progression in chronic kidney disease (CKD) patients. At this stage, a variety of clinical manifestations, such as hypertension, anemia, and edema, and metabolic and endocrine disorders can occur; renal replacement therapy, such as hemodialysis (HD), is needed to remove excess water and metabolic wastes from the extracorporeal blood and to maintain the electrolyte and acid-base balance [1]. The effects of HD on the posterior pole include changes in
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