The effect of hemodialysis on intraocular pressure

Background. The effect of hemodialysis (HD) on intraocular pressure (IOP) has been investigated before, but there is a lack of consensus. Clinicians dealing with renal failure patients are interested in the potential negative effects of HD on IOP and the course of glaucoma. Objectives. The aim of this study was to investigate the effects of HD on IOP in patients with end-stage renal disease. Material and methods. This prospective study included 106 patients who were receiving outpatient hemodialysis. Patient history of systemic and ophthalmologic conditions was recorded. Serum osmolality (mOsm), blood urea nitrogen (BUN), blood glucose (BG), bicarbonate (BC), and hematocrit (Hct) levels at the start of HD (pre-HD), at the end of HD (end-HD), and 30 min after HD (post-HD) were measured. Systolic and diastolic blood pressures (SBP and DBP) and IOP were measured at pre-HD, 1-hour intervals during HD, end-HD, and post-HD. Results. A significant decrease in mOsm and BUN and a significant increase in BG, BC, and Hct levels were observed at end-HD (p < 0.05). Mean IOP was 16.71 +/- 2.51 mm Hg at pre-HD, 15.52 +/- 3.18 mm Hg at end-HD, and 15.23 +/- 2.73 mm Hg at post-HD (p = 0.001; F = 4.439). Post-HD SBP and DBP were significantly lower than at pre-HD (p < 0.001). There was a positive correlation between the change in IOP and the change in mOsm and the change in BUN at end-HD (r = 0.315, p = 0.004; and r = 0.279, p = 0.012, respectively). Conclusions. IOP decreased significantly during HD in this study. Additional research on the effects of the change in blood parameters and ocular perfusion pressure on IOP and optic nerve perfusion during HD is recommended.