Ocular Manifestations in Chronic Renal Failure Patients
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 3
Abstract
The study was done during a period of two years from november 2011 to September 2013 on 200 consecutive patients who were admitted to the nephrology ward, Kurnool medical college, Kurnool and met the inclusion and exclusion criteria. Inclusion criteria: All cases diagnosed as chronic renal failure. Exclusion criteria: Cases of reversible renal failure, Patients on peritonial dialysis. Chronic kidney disease (CKD) is a worldwide public health problem, both for the number of patients and cost of treatment involved. Globally, CKD is the 12th cause of death and the 17th cause of disability, respectively. The chronic diseases account for 60% of all deaths worldwide. 80% of chronic disease deaths worldwide occur in low and middle socio economic countries 1 . In India the projected number of deaths due to chronic disease was around 5.21 million in 2008 and is expected to raise to 7.63 million in 2020 ( 66.7% of all deaths)2. As a part of multi organ involvement, eye is not an exception. The common Ocular manifestations include some anterior segment manifestations like lid puffiness, conjuctival pallor, conjuctival &corneal calcification, posterior segment manifestations like hypertensive retinopathy, diabetic retinopathy, CSME, maculopathy, retinal detachment. Chronic renal failure is irreversible and progressive process that results in end stage renal disease where patient has to be dependent on renal replacement therapy for survival 5 . The most common cause of CRF is diabetic nephropathy followed by hypertensive nephro angiosclerosis and various primary and secondary glomerulo nephropathies. This study is an attempt to access the ocular status/complications associated with CRF. To analyse the ocular status/complications in the patients with chronic renal failure.To screen patients for any potential visual threat so that necessary treatment and or advice can be given before they become irreversibly visually impaired. Admissions due to CRF ( Chronic renal failure ) the patients were 1308 (69.5%) the common age affected being 40 to 80 years ( 65%) male dominant 143 patients ( 71.5%), CRF with DM 55 patients ( 27.5%), CRF with HTN 45 patients (22.5%), patients with diminished vision 124 patients(62%) patients with DM,Maculopathy 39 patients (9.75%), patients with PDR 24 patients (5.8%), Conjunctival Pallor 152 patients ( 75.60%), Lid Oedema 126 patients(63%) Diabatic retinopathy 64 patients (88.8%), Hypertensive retinopathy 31 patients (47%). These above results are observed by us in our study. we aimed to prospectively analyze the ocular manifestations among CRF patients . A detailed history, detailed ophthalmic examination was done for all the cases and recorded. When CRF patients were evaluated the patients in the age group of 40-80 years were commonly affected . There was a definite male preponderance among the cases. The most common aetiological factor leading to CRF in these patients is diabetes mellitus followed by hypertension and some are due to glomerulonephritis and Autosomal dominant polycystic kidney disease. Diminished vision was the most common symptom seen with CRF patients and it was commonly attributed to maculopathy followed by cataract and PDR.lid puffiness and conjuctival pallor were the most common signs observed in CRF patients. These findings are statistically significant and can be regarded as consistent finding in CRF. Among the posterior segment signs hypertensive retinopathy findings are most common followed by diabetic retinopathy. Ocular manifestations are common in CRF patients. The most frequently encountered manifestations in CRF is conjuctival pallor and lid edema. The most common cause of CRF in our study is diabetes mellitus. Regular screening for diabetic retinopathy in cases of CRF can help patients with early intervention with laser photocoagulation and alert physician for more aggressive management of diabetes. Ocular condition is an indicator of the metabolic control of the disease process.
Authors and Affiliations
Dr. G. Narendranath Reddy
Keywords
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