Abstract
Background
Patients with chronic renal failure are commonly cared using a blood filtration mechanism like hemodialysis. Little information is available regarding ocular changes following hemodialysis for people with chronic renal failure. Accordingly, this study intended to estimate the pre- and post-hemodialysis thickness of retina and choroid and other ocular findings in patients with chronic renal failure.
Methods
This research is a “before and after” clinical experiment, without control. This prospective study was conducted on patients with chronic renal failure who were in Imam Khomeini Hospital for hemodialysis in 2017. The sample size of this study was estimated to be 67 (134 eyes). In this study, after acquiring consent (by the associated assistant) from all patients, thorough ocular examinations including IOP control, VA and fundus examination, reflection, and macula and choroid OCT were performed 30 min before and after hemodialysis and entered in SPSS V. 16 software by the project manager. Finally, these data were analyzed practicing T-pair tests or their nonparametric equivalent, the Wilcoxon test.
Results
Based on the results of this examination, studying 67 participating patients, 134 eyes were examined, of which 80 eyes (59.8%) belonged to men, and 54 eyes (40.2%) belonged to women. The mean and standard deviation of participants’ age in the study was reported to be 57.3 ± 15 years, and the dialysis duration was 3.0 ± 2.11 h. According to the Wilcoxon test, the average rank in terms of weight, patient temperature, pulse, blood sugar, urea, potassium, ocular pressure, 500-micron nasal choroidal thickness, and myopia in diopter vary significantly before and after dialysis (p < 0.05). However, according to the Wilcoxon test, choroidal thickness in the subfoveal area of the eye (p = 0.600), the retinal thickness in the subfoveal area (p = 0.839), the amount of astigmatism in diopter (p = 0.757) and the amount of hypermetropia in diopter (p = 0.068) before and after dialysis do not have a significant difference. Based on the t test, it was reported that the average creatinine score, the best corrected vision, and the 500 and 1000-micron temporal and nasal choroidal thickness had a significant difference (p < 0.05).
Conclusion
Based on the results of the current study, it was settled that the corrected vision, ocular pressure, as well as the 500-micron nasal choroidal thickness, and myopia in diopter and the 1000-micron temporal and nasal choroidal thickness of patients before and after hemodialysis vary. This difference shows the impact of hemodialysis on changes in ocular characteristics in patients with renal insufficiency.
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Data Availability
Datasets are available through the corresponding author upon reasonable request.
Abbreviations
- IOP:
-
Intraocular pressure
- VA:
-
Visual acuity
- GCL:
-
Ganglion cell layer
- INL:
-
Inner nucleotide layer
- OCT:
-
Optical coherence tomography
- CFT:
-
Central foveal thickness
References
Chang IB, Lee JH, Kim JS (2017) Changes in choroidal thickness in and outside the macula after hemodialysis in patients with end-stage renal disease. Retina (Philadelphia, Pa.) 37(5):896
Kal A, Kal O, Eroglu FC, Oner O, Kucukerdonmez C, Yilmaz G (2016) Evaluation of choroidal and retinal thickness measurements in adult hemodialysis patients using spectral-domain optical coherence tomography. Arquivos brasileiros de oftalmologia 79(4):229–232
American Academy of Oththalmology, Dale E, Fajardo, EdD, MBA Beth Wilson, Daniel Mummert Christine A. Jasmine Chen Stephania Tanaka, Eric Gerdes D. Jean Ray, Donna Scism Ann McGuire, Crissa Williams, Section 12, Part I Fundamentals and Diagnostic Approaches, Part II Disorders of the Retina and Vitreous, 2015–2016
Ulas F, Dogan U, Keles A, Ertilav M, Tekce H, Celebi S (2013) Evaluation of choroidal and retinal thickness measurements using optical coherence tomography in non-diabetic hemodialysis patients. Int Ophthalmol 33(5):533–539
Tosun O, Davutluoglu B, Arda K, Boran M, Yarangumeli A, Kurt A, Ozkan D (2017) Determination of the effect of single hemodialysis session on retrobulbar blood hemodynamics by color Doppler ultrasonography. Acta Radiol 48(7):763–767
Jung JW, Yoon MH, Lee SW, Chin HS (2013) Effect of hemodialysis (HD) on intraocular pressure, ocular surface, and macular change in patients with chronic renal failure. Graefe’s Arch Clin Exp Ophthalmol 251(1):153–162
Rever B, Fox L, Barkhayim Y, Nissenson A (1981) Adverse ocular effects of acetate hemodialysis. In: Kidney International, vol 19, no 1, pp 157–157
Dinc UA, Ozdek S, Aktas Z, Guz G, Onol M (2010) Changes in intraocular pressure, and corneal and retinal nerve fiber layer thickness during hemodialysis. Int Ophthalmol 30(4):337–340
Afshar R, Ghasemi H, Shabpiray H, Abdi S, Davati A, Zerafatjou N, Askari MK (2013) Monitoring of intraocular pressure and its correlation with systemic parameters before and after hemodialysis. Iran J Kidney Dis 7(1):53
Tokuyama T, Ikeda T, Ishikawa H, Sato K (1997) Marked decrease in intraocular pressure in a neovascular glaucoma patient during hemodialysis. Jpn J Ophthalmol 41(2):101–103
Zazzeroni L, Pasquinelli G, Nanni E, Cremonini V, Rubbi I (2017) Comparison of quality of life in patients undergoing hemodialysis and peritoneal dialysis: a systematic review and meta-analysis. Kidney Blood Press Res 42(4):717–727
Pierratos A (2002) Daily hemodialysis: an update. Curr Opin Nephrol Hypertens 11(2):165–171
Arefzadeh AR, Lesan-Pezeshki M, Safi S, Khatami MR (2008) The cost of hemodialysis. J Med Counc Islam Republic Iran 26(1):76–82
USRDS (2003) The United States renal data system. Am J Kidney Dis 42(Suppl 5):1–230
Barsoum RS (2006) Chronic kidney disease in the developing world. New Engl J Med 354(10):997–999
Lesan-Pezshki M, Matini M, Tagadosi M (2001) Assessment of quality of dialysis in Kashan. Fayze J 17(2):82–87
Haghighi AN (2002) The epidemiology of end stage renal disease in Iran in an international perspective. Nephrol Dial Transpl 17(1):28–32
Rezapour A, Ebadifardazar F, Arablou J (2012) An analysis of dialysis costs in Iran: the cost of hemodialysis in patients attending Buoalisina helath care center. Ghazvin Univ Med Sci Payesh 11(4):435–442
Salimi H, Tayebi A (2010) A survey on relationships between mental health related factors (stress, depression, anxiety) and marital satisfaction in hemodialysis patients. J Nephrourol Mon 2(2):335–344
Martins Castro MC, Luders C, Elias RM, Abensur H, Romão Junior JE (2006) High-efficiency short daily haemodialysis-morbidity and mortality rate in a long-term study. Nephrol Dial Transpl 21(8):2232–2238
Salahi H, Mehdizadeh AR, Derakhshan A et al (2004) Evaluation the course of end stage renal disease (ESRD) in kidney transplant patients-a single center study. Iran J Med Sci 29(4):198–204
Martins D, Tareen N, Norris KC (2002) The epidemiology of end-stage renal disease among african americans. Am J Med Sc 323(2):65–71
Kher V (2002) End-stage renal disease in developing countries. Kidney Int 62(1):350–362
Eslami F, Bazzazi N, Alizade M (2017) Frequency of ocular manifestation in hemodialysis patients. Sci J Hamadan Univ Med Sci 24(1):32–40
Narimani K (2006) A study of quality of life in end stage renal diseaseundergoing hemodialysis treatment. Sci J Hamadan Nurs Midwif Fac 14(2):26–36
Udayakumar P, Balasubramanian S, Ramalingam KS, Lakshmi C, Srinivas CR, Mathew AC (2006) Cutaneous manifestations in patients with chronic renal failure on hemodialysis. Indian J Dermatol Venereol Leprol 72(2):119–125
Tol A, Esmaeil Shahmirzadi S, Moradian Sorkhkolaee M, Azam K (2012) Determination of quality of life of dialysis and kidney transplant patients compared to healthy people. J Res Health Syst 1390(7):6
Khatatbeh AE, Maryan MN, Al Bderat AT (2013) Ophthalmic findingsamong Jordanian patients with Chronic Renal Failure on Haemodialysis at Prince Ali Military Hospital in the South of Jordan. J R Med Serv 20(3):62–67
Tomazzoli L, De Natale R, Lupo A, Parolini B (2000) Visual acuity disturbances in chronic renal failure. Ophthalmologica 214(6):403–405
Chelala E, Dirani A, Fadlallah A, Slim E, Abdelmassih Y, Fakhoury H (2015) Effect of hemodialysis on visual acuity, intraocular pressure, macular thickness in patients with chronic kidney disease. Clin Ophthalmol 9:109–114
Ghanbari H, Dehghani A, Mahboubi MR, Rezaei L, Feizi A (2016) The changes of choroidal thickness of patients with retinal detachment after scleral buckling using enhanced depth imaging (EDI)-OCT in Isfahan Feiz Hospital in 2015. Int J Adv Biotechnol Res 7(3):990–1000
Ojo AO, Held PJ, Port FK, Wolfe RA, Leichtman AB, Young EW, Arndorfer J, Christensen L, Merion RM (2003) Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med 349(10):931–940
Schott HC (2007) Chronic renal failure in horses. Vet Clin North Am Equine Pract 23(3):593–612, vi
Khoury T, Tzukert K, Abel R, Abu Rmeileh A, Levi R, Ilan Y (2017) The gut-kidney axis in chronic renal failure: a new potential target for therapy. Hemodial Int 21(3):323–334
Coulthard MG (2016) The management of neonatal acute and chronic renal failure: a review. Early Hum Dev 102:25–29
Theodossiadis PG, Theodoropoulou S, Neamonitou G, Grigoropoulos V, Liarakos V, Triantou E, Theodossiadis GP, Vlahakos DV (2012) Hemodialysis-induced alterations in macular thickness measured by optical coherence tomography in diabetic patients with end-stage renal disease. Ophthalmologica 227(2):90–94
Borisov VV, Shilov EM (2016) Chronic renal failure. Urologiia (3Suppl 3):28–35
Proctor R, Kumar N, Stein A, Moles D, Porter S (2005) Oral and dental aspects of chronic renal failure. J Dent Res 84(3):199–208
Al Shakarchi J, Houston JG, Jones RG, Inston N (2015) A review on the hemodialysis reliable outflow (HeRO) graft for haemodialysis vascular access. Eur J Vasc Endovasc Surg 50(1):108–113
Basile C, Casino F, Kalantar-Zadeh K (2017) Is incremental hemodialysis ready to return on the scene? From empiricism to kinetic modelling. J Nephrol 30(4):521–529
Elliott DA (2000) Hemodialysis. Clin Tech Small Anim Pract 15(3):136–148
Fadili W, Adnouni A, Laouad I (2016) Hemodialysis safety: evaluation of clinical practice. Saudi J Kidney Dis Transpl 27(3):553–556
Moustapha CM, Tall LA, Maria F, Khodia F, Moustapha F, Fary Kel H, Abdou N, Boucar D (2016) Evaluation of cardiac complications among chronic hemodialysis in Dakar. Pan Afr Med J 23:43
Kim YL (2017) What is the best dialysis therapy in developed and developing countries? Peritoneal dialysis and/or hemodialysis: the trend in Korea. Contrib Nephrol 189:65–70 (Epub 2016 Dec 12)
Wong B, Ravani P, Oliver MJ, Holroyd-Leduc J, Venturato L, Garg AX, Quinn RR (2018) Comparison of patient survival between hemodialysis and peritoneal dialysis among patients eligible for both modalities. Am J Kidney Dis 71(3):344–351
Rosner MH (2005) Hemodialysis for the non-nephrologist. South Med J 98(8):785–791 (quiz 792-3)
Derakhshandeh J, Khanjani S (2001) [A survey of the effects of ophtalmic complications on dialysis patients in zanjan beheshti hospital during2001-2002. J Zanjan Univ Med Sci 9(35):10–13
Acknowledgements
The authors thank the faculty members of the Faculty of Medicine, Kermanshah University of Medical Sciences.
Funding
This study was funded by deputy of research and technology, Kermanshah University of Medical Sciences (980863).
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FSH and SB contributed to the design. NS helped in statistical analysis and participated in most of the study steps. SB and LR prepared the manuscript. LR and NS and SB and NA assisted in designing the study and helped in the interpretation of the study. All authors have read and approved the content of the manuscript.
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Ethics approval was received from the ethics committee of deputy of research and technology, Kermanshah University of Medical Sciences (980863), and informed consent obtained from study participants was written.
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Shoshtari, F.S., Biranvand, S., Rezaei, L. et al. The impact of hemodialysis on retinal and choroidal thickness in patients with chronic renal failure. Int Ophthalmol 41, 1763–1771 (2021). https://doi.org/10.1007/s10792-021-01735-y
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DOI: https://doi.org/10.1007/s10792-021-01735-y