Intraocular pressure changes during hemodialysis

Liakopoulos, Vassilios; Demirtzi, Paraskevi; Mikropoulos, Dimitrios G.; Leivaditis, Konstantinos; Dounousi, Evangelia; Konstas, Anastasios G. P.

doi:10.1007/s11255-015-1043-8

Cited by 19 publications

(19 citation statements)

References 26 publications

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“…There is controversy regarding the effect of hemodialysis on intraocular pressure. Although some studies have demonstrated that intraocular pressure may decrease or remain stable after hemodialysis 23 , most studies describe an increase in IOP during hemodialysis 15 16 17 18 . Various theories about the relationship between elevated IOP and hemodialysis have been postulated, and the most well-accepted theory suggests an influx of volume into the posterior chamber via the ciliary body due to an imbalance in osmolality between the ocular chamber and the blood during hemodialysis 24 .…”

Section: Discussionmentioning

confidence: 99%

Risk of Band Keratopathy in Patients with End-Stage Renal Disease

Weng

Jan

Chang

et al. 2016

Sci Rep

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This study is a retrospective, nationwide, matched cohort study to investigate the risk of band keratopathy following end-stage renal disease (ESRD). The study cohort included 94,039 ESRD on-dialysis patients identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 585 and registered between January 2000 to December 2009 at the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,039 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. In total, 230 ESRD patients and 26 controls had band keratopathy (P < 0.0001) during the follow-up period, indicating a significantly elevated risk of band keratopathy in the ESRD patients compared with controls (incidence rate ratio = 12.21, 95% confidence interval [CI] = 8.14–18.32). After adjustment for potential confounders including sarcoidosis, hyperparathyroidism, iridocyclitis, and phthisis bulbi, ESRD patients were 11.56 times more likely to develop band keratopathy in the full cohort (adjusted HR = 11.56, 95% CI = 7.70–17.35). In conclusion, ESRD increases the risk of band keratopathy. Close interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with band keratopathy following ESRD and prevent visual acuity impairments.

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Section: Discussionmentioning

confidence: 99%

Risk of Band Keratopathy in Patients with End-Stage Renal Disease

Weng

Jan

Chang

et al. 2016

Sci Rep

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“…The effects of hemodialysis on IOP changes remain uncertain. In 2015, Liakopoulos et al 10 published a review and discussed the changes in IOP in relation to hemodialysis in three groups: those with increased IOP, those with reduced IOP, and those without any change in IOP. Accordingly, the authors found that while the first studies had been carried out with longer and less effective hemodialysis systems, the development of more effective dialysis membranes and devices in recent years significantly prevented increases in IOP.…”

Section: Discussionmentioning

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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“…Alterations to the composition of vitreous humour in pseudophakic eyes after cataract surgery was discovered by Neal et al 22 and they suggested that these alterations may contribute to the retinal complications after cataract surgery. In ESRD patients, changes in intraocular pressure (IOP) [23][24][25] and ocular structures 26,27 during HD were reported in different studies. The ocular structure changes include decrease in choroidal thickness and retina thickness after HD.…”

Section: Discussionmentioning

confidence: 99%

Cataract surgery-related complications in patients with end-stage renal disease- a nationwide population-based study in Taiwan

Hsiao

Liang

et al. 2020

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this nationwide retrospective case-control study was aimed at elucidating the risk from cataract surgery in end-stage renal disease (ESRD) patients. Cataract surgery patients were identified using the diagnostic and procedural codes for International Classification of Diseases, 9 th Revision, Clinical Modification from Taiwan's National Health Insurance Research Database. ESRD patients were selected as cases, while propensity scores for age, sex, comorbidities and year-of-surgery-matched patients without chronic kidney disease constituted the controls. patients who had undergone eye surgery within 3 years before cataract surgery were excluded. The main outcome measures were target cataract surgery-related complications within 3 months after surgery. A total of 352 cases and 1,760 controls were analysed. Patients with ESRD had a 5.06-fold (95% CI: 2.36-10.87; p < 0.001) risk of vitreous haemorrhage and a 2.74-fold (95% CI: 1.20-6.27; p = 0.017) risk of re-operation for dropped nucleus or vitreous complications. Non-diabetic ESRD patients had a 3.49-fold (95% CI: 1.36-8.91; p = 0.009) risk of corneal oedema. In conclusion, ESRD patients have a higher risk of vitreous haemorrhage, reoperation for dropped nucleus or vitreous complications and corneal oedema (non-diabetic patients) after cataract surgery. Pre-surgery corneal examination, surgery procedure and medication adjustment, closer and longer post-surgery follow-up may lower the risk and improve the visual outcome.Cataract is the most common cause of blindness worldwide, and successful cataract surgery restores vision to most patients. Although cataract surgery is a minor procedure, complications sometimes develop that influence the visual outcome. In particular, cataract surgery can lead to glaucoma, vitreous haemorrhage (VH), retinal detachment, intraocular dislocation, dropped nucleus, and wound dehiscence 1 .Patients with end-stage renal disease (ESRD) were reported to have an increased risk of complications such as bleeding, infection and perioperative mortality when they received major inpatient surgeries 2-4 . ESRD patients were noted to have a higher risk of cataract 5 . Only a few studies have reported cataract surgery-related risk in ESRD patients 6,7 , and these studies involved only a small number of patients and no control group.The purpose of the present study was to elucidate the risk of cataract surgery-related complications in patients receiving dialysis and to compare this risk to those in patients without chronic kidney disease (CKD) or ESRD. As such, the study may inform better patient care and improve surgical outcomes.

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Intraocular pressure changes during hemodialysis

Cited by 19 publications

References 26 publications

Risk of Band Keratopathy in Patients with End-Stage Renal Disease

Risk of Band Keratopathy in Patients with End-Stage Renal Disease

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

Cataract surgery-related complications in patients with end-stage renal disease- a nationwide population-based study in Taiwan

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