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

Abstract

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.

Evaluation of Dry Eye Using Anterior Segment Optical Coherence Tomography in Patients With End‐Stage Renal Disease Undergoing Hemodialysis

“…There were 20 females in the study group and 21 females in the control group and there was no statistically significant difference in gender (P = 0.47). Mean duration of hemodialysis in the study group was 4.36 AE 2.92 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) 2 in study group and 0.114 AE 0.027 mm 2 in control group (P < 0.05). There was a statistically significant difference in all tear meniscus measurements using AS-OCT (Table 2).…”

“…Hormonal changes, metabolic imbalances and toxic conditions such as uremia lead to the development of ocular findings. The most common ocular findings associated with chronic renal failure are focal or diffuse conjunctival hyperemia, pingueculae as a result of conjunctival degeneration, metastatic calcification on conjunctival and corneal surface, conjunctival cytological changes which are not correlated, calcium deposit grades and conjunctival squamous metaplasia not correlated, serum aluminum, calcium levels, dry eye, band keratopathy, cataracts, macular edema, ischemic optic neuropathy, elevated intraocular pressure, retinal detachment, and retinal hemorrhage .…”

EDTA chelation for symptomatic band keratopathy: results and recurrence

“…1,2 It can be classified as primary or secondary, with a variety of predisposing systemic and ocular conditions, including renal failure, elevated serum calcium levels, chronic ocular inflammation, corneal ulcers, alkali chemical burns (and phosphate-based irrigating solutions), and a compromised ocular surface due to adverse reactions to preservatives/ buffers in ocular drops, particularly in patients on life-long therapy. [1][2][3][4][5] Familial band keratopathy has also been reported. 6 The natural history of band keratopathy is gradual progression over many months/years; however, there have been isolated reports of acute incidence following intra-cameral injection of tissue plasminogen activator to treat postoperative fibrinous reaction.…”

Risk of serous retinal detachment in patients with end-stage renal disease on dialysis

“…The study has high statistical power and increased precision in risk appraisal because it is based on a nationwide population-based dataset, including a large sample of patients with ESRD on dialysis. Several previous studies using the same database have already been published [ 9 , 32 , 33 ]. Furthermore, our study is a cohort study analysing the incidence of serous retinal detachment in patients with ESRD on dialysis, with comparisons between cohorts over a 10-year period.…”