Ocular Fundus Abnormalities in Pre-Dialytic Chronic Kidney Disease Patients

• 作者: A. H. Hamid Ahmed A. K. M. Shahidur Rahman Asia Khanam K. B. M. Hadiuzzaman Manik Chandra Mondal Md. Azizur Rahman Md. Omar Faroque Mohammad Kamrul Ahsan Muhammad Rafiqul Alam Rafi Nazrul Islam
• 来源期刊: 生物科学与医学(英文)
• 学科: 医学
• 关键词: Chronic KIDNEY Disease (CKD) OCULAR FUNDUS RETINOPATHY
• 年，卷（期）: 2019,（11）
• 页码范围: 20-35
• 页数: 16页
• 分类号: R69

摘要

Background: Chronic kidney disease (CKD) affects 10% - 16% of the adult population. Although ocular findings related to renal insufficiency include cataract, conjunctival calcification, lid edema, conjunctival pallor and xanthalesma, by far the most important is retinopathy. Objective: To evaluate the ocular fundus abnormalities in pre-dialytic chronic kidney disease patients of the adult population. Methodology: This cross-sectional observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2012 to March 2014. A total of 100 hospital admitted CKD patients were purposively selected for this study. Age, gender, blood pressure, Body Mass Index (BMI), 24 hours Urinary Total Protein (UTP), haemoglobin level, serum creatinine, serum cholesterol, serum triglyceride and color fundus photography findings of both eyes were recorded for each patient. Inter-group comparisons were made between patients with retinopathy and those without retinopathy. Results: Out of 100 adult non-dialytic CKD patients, 43 (43%) had ocular fundus abnormalities, among them 27 (62.8%) were male and 16 (37.2%) were female. The risk of development of retinopathy was significantly higher among older patients (p = 0.006), those with low haemoglobin level (p = 0.0001) and high blood pressure. Retinopathy was significantly (p = 0.0001) increased with reduction of e-GFR. There was no relationship between BMI and high serum triglyceride level with retinal abnormality. Among 43 (43%) patients with retinal abnormality, 30 (69.76%) patients showed only hypertensive retinopathy and 5 (11.6%) patients showed only diabetic retinopathy. Mixed hypertensive and diabetic retinopathy was found in 8 (18.6%) patients. Maculopathy was seen in 11 (25.58%) patients, of whom 3 (6.98%) had hypertensive retinopathy and 8 (18.87%) had diabetic retinopathy. Optic atrophy was seen in 2 (4.6%) patients and drusen like retinal deposits were seen in 2 (4.6%) patients. Conclusion: Ocular fu