Abstract
Background: Chronic kidney disease (CKD) affects 10% - 16% of the adult population. Although ocular findings related to renal insufficiency include cataract, conjunctival calcification, lid edema, conjunctival pallor and xanthalesma, by far the most important is retinopathy. Objective: To evaluate the ocular fundus abnormalities in pre-dialytic chronic kidney disease patients of the adult population. Methodology: This cross-sectional observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2012 to March 2014. A total of 100 hospital admitted CKD patients were purposively selected for this study. Age, gender, blood pressure, Body Mass Index (BMI), 24 hours Urinary Total Protein (UTP), haemoglobin level, serum creatinine, serum cholesterol, serum triglyceride and color fundus photography findings of both eyes were recorded for each patient. Inter-group comparisons were made between patients with retinopathy and those without retinopathy. Results: Out of 100 adult non-dialytic CKD patients, 43 (43%) had ocular fundus abnormalities, among them 27 (62.8%) were male and 16 (37.2%) were female. The risk of development of retinopathy was significantly higher among older patients (p = 0.006), those with low haemoglobin level (p = 0.0001) and high blood pressure. Retinopathy was significantly (p = 0.0001) increased with reduction of e-GFR. There was no relationship between BMI and high serum triglyceride level with retinal abnormality. Among 43 (43%) patients with retinal abnormality, 30 (69.76%) patients showed only hypertensive retinopathy and 5 (11.6%) patients showed only diabetic retinopathy. Mixed hypertensive and diabetic retinopathy was found in 8 (18.6%) patients. Maculopathy was seen in 11 (25.58%) patients, of whom 3 (6.98%) had hypertensive retinopathy and 8 (18.87%) had diabetic retinopathy. Optic atrophy was seen in 2 (4.6%) patients and drusen like retinal deposits were seen in 2 (4.6%) patients. Conclusion: Ocular fundus abnormalities are common among adult pre-dialytic CKD patients. Retinopathy is significantly higher in advanced stages of CKD.
Highlights
Chronic kidney disease (CKD) is an irreversible and progressive process
This hospital based cross sectional study was done in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2012 to March 2014 to evaluate the ocular fundus abnormalities in pre-dialytic chronic kidney disease patients of adult population
Retinopathy defined as vascular pathology as a result of diabetes, hypertension or other conditions
Summary
Chronic kidney disease (CKD) is an irreversible and progressive process. It affects 10% - 16% of the adult population in Asia, Australia, Europe and the United States [1]. It is shown that, several types of ocular fundus abnormalities has been associated with CKD such as microvascular retinopathy, diabetic retinopathy, macular degeneration, retinal hemorrhage [3] [4]. Chronic kidney disease (CKD) affects 10% - 16% of the adult population. Objective: To evaluate the ocular fundus abnormalities in pre-dialytic chronic kidney disease patients of the adult population. Results: Out of 100 adult non-dialytic CKD patients, 43 (43%) had ocular fundus abnormalities, among them 27 (62.8%) were male and 16 (37.2%) were female. Mixed hypertensive and diabetic retinopathy was found in 8 (18.6%) patients
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