5 Ocular Changes in Hemodialysis Patients

• Published in: Therapeutic apheresis and dialysis Vol. 9; no. 1; p. 79
• Main Authors: Pavlović, D, Vatavuk, Z, Vrabec, R, Čala, S, Sesar, A, Ratković-Gusić, I, Mandić, Z
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2005
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/j.1526-0968.2005.222_5_5.x

Chronic renal failure is characterized by numerous disorders that involve many organs. In dialysis patients, some disorders could be the consequence of the dialysis treatment per se. The aim of our study was to evaluate the ocular changes in hemodialysis patients. In 64 patients undergoing hemodialysis (30 female and 34 male), aged 24–83 years (mean 58 years) and on hemodialysis 1–213 months (mean 47 months), complete ocular examination was performed: visual acuity (VA), intraocular pressure (IOP), biomicroscopic examination, and fundoscopy. All patients were on hemodialysis 3 times a week, for 4 hours; bicarbonate dialysate was used with 1.5 mmol/L Ca concentration. Most of the patients were on calcitriol therapy and calcium carbonate were used as phosphate binders. Heparin was used during hemodialysis in all patients in a dose up to 4000 i.u. Visual acuity was impaired in 84% of patients; mean IOP was 15 mmHg (right eye) and 14 mmHg (left eye) (normal vale 11–20 mmHg). Thirty‐nine patients (60%) have cataracts, 6 of them were operated. Hypertensive vascular changes were seen in 44 (68%) patients and in 6 patients age related macular degeneration was observed. Diabetic nonprolipherative or prolipherative changes were seen in 5 of 7 diabetic patients. In 3 patients, argon laser coagulopathy was performed. Ocular calcifications were found in 14 patients. No correlation of ocular calcification and parathyroid hormone PTH level or calcium–phosphate product was observed. Patients with CRF or who are receiving dialysis represent a unique group of patients. Pathologic changes could be found in many organs; therefore, we suggest more frequent complete ocular examination in dialysis patients.