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. 2025 Mar 12:19:827-834.
doi: 10.2147/OPTH.S513421. eCollection 2025.

Effect of Hemodialysis on Glaucoma Patients

Tina M Hendricks  1 , Tyler S Quist  1 , Kai Wang  2 , Lisa M Antes  3 , Erin A Boese  1
Affiliations

Effect of Hemodialysis on Glaucoma Patients

Tina M Hendricks et al. Clin Ophthalmol. .

Abstract

Purpose: Prospective study to determine if patients with glaucoma are at increased risk of intraocular pressure (IOP) fluctuation and changes in ocular perfusion pressure (OPP) during hemodialysis (HD) sessions when compared to patients without glaucoma.

Patients and methods: Patients undergoing HD at the University of Iowa for end-stage renal disease were recruited. Enrollment was restricted to patients undergoing standard HD sessions for a minimum of three months. Hand-held slit lamp examination, IOP, blood pressure (BP), and central corneal thickness (CCT) measures were taken at the following three time points: the beginning of the session (before), at the half-way point (middle), and at the conclusion of the session (end). Ocular perfusion pressure was calculated using the formula: 2/3[diastolic BP + 1/3 (systolic BP - diastolic BP)] - IOP.

Results: Every eligible patient having dialysis was approached, and 105 eyes of 54 patients were recruited for the study. The glaucoma cohort included 19 eyes from 11 patients. The variability in IOP from the beginning to the end of HD (end-before) was 1.54 mmHg greater in the glaucoma group (p=0.005), with some glaucoma patients having IOP increases up to 25 mmHg. Ocular perfusion pressure decreased significantly more in glaucoma patients compared to controls at both middle-before (p=0.008), and end-before (p=0.01) time points.

Conclusion: Glaucoma patients may be more vulnerable to IOP swings and drops in OPP during HD sessions compared to controls. In all cases, these changes were asymptomatic, potentially placing glaucoma patients at increased risk for glaucomatous progression during each HD session. Our results suggest that HD may be an independent risk factor for glaucomatous progression, and may be especially worth investigating in patients with progression despite low to normal IOPs measured in clinic.

Keywords: dialysis; glaucoma; hemodialysis; intraocular pressure fluctuation; ocular perfusion pressure.

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Conflict of interest statement

The authors have no conflicts of interest in this work.

References

    1. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12(1):7–11. doi:10.1016/j.kisu.2021.11.003 - DOI - PMC - PubMed
    1. Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Kidney Int. 2019;96(5):1048–1050. doi:10.1016/j.kint.2019.07.012 - DOI - PubMed
    1. Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2019 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2020;75(1 Suppl 1):A6–A7. doi:10.1053/j.ajkd.2019.09.003 - DOI - PubMed
    1. Sun G, Hao R, Zhang L, et al. The effect of hemodialysis on ocular changes in patients with the end-stage renal disease. Ren Fail. 2019;41(1):629–635. doi:10.1080/0886022X.2019.1635494 - DOI - PMC - PubMed
    1. Saavedra-Fuentes N, Perez-Grovas H, Navarrete R, Lerma C. Intraocular pressure changes during hemodialysis or hemodiafiltration in end-stage renal disease patients. Ther Apher Dial. 2018;22(6):624–629. doi:10.1111/1744-9987.12707 - DOI - PubMed

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