Corneal disease in patients with chronic renal insufficiency undergoing hemodialysis.
OBJECTIVE
To evaluate alterations of the corneal endothelium in patients undergoing hemodialysis for renal insufficiency.


METHODS
Sixty-six patients undergoing hemodialysis received a complete ophthalmologic examination. The state of the endothelium was assessed using pachymetry and specular microscopy. The group of patients undergoing dialysis was divided according to the time of dialysis, aluminum, product of calcium and phosphate in blood, and parathyroid hormone to analyze the influence of these factors. The possible presence of iron and aluminum in the aqueous humor of patients who underwent and those who did not undergo hemodialysis was also estimated.


RESULTS
Patients undergoing hemodialysis did not have significant corneal edema. Cell density was significantly lower in patients undergoing dialysis than in patients not undergoing dialysis; this reduction appeared to be associated with length of dialysis and was unrelated to serum aluminum and calcium levels. Patients undergoing dialysis did not have cell polymorphism or polymegethism, although there was a tendency toward increased polymegethism with length of dialysis. Aluminum and iron were not increased in the aqueous humor of patients undergoing dialysis.


CONCLUSIONS
The alteration of the endothelium that we found is not related to the elements studied. It is possibly the result of another product dissolved in the anterior chamber or to the alterations of the anterior segment that these patients are known to have.
Diaz-Couchoud
P
P
Ophthalmology Service, Hospital Clinic i Provincial, C/Enric Granados 45 pral 2, 08008 Barcelona, Spain. 26767pdc@comb.es
Bordas
F D
FD
Garcia
J R
JR
Camps
E M
EM
Carceller
A
A
D000328:Adult; D000535:Aluminum / Q000032:analysis; D001082:Aqueous Humor / Q000737:chemistry; D017610:Calcium Compounds / Q000032:analysis; D002452:Cell Count; D048429:Cell Size; D003316:Corneal Diseases / Q000150:complications* / Q000175:diagnosis; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000032:analysis; D006435:Renal Dialysis
D017610:Calcium Compounds; D010281:Parathyroid Hormone; D010710:Phosphates; D000535:Aluminum