title: Management of intraocular hypertension during hemodialysis by intravenous glucose administration.
abstract: A 64-year-old woman with end-stage renal disease and retinopathy secondary to type 2 diabetes mellitus presented with recurrent episodes of left ocular pain and acute loss of visual acuity during hemodialysis. During these episodes, markedly elevated intraocular pressures were measured. Several local and systemic antiglaucoma drugs were administered without improvement of intraocular pressure, resulting in the necessity of a glaucoma drainage device (Ahmed valve). Due to a local infection, it had to be removed, after which intraocular pressure elevations recurred during hemodialysis. Assuming that intraocular changes in osmolality during hemodialysis caused the intraocular pressure increases, intradialytic administration of a 20% glucose solution (100mL/h) was initiated. This completely abrogated the development of both intraocular pain and increases in intraocular pressure.
authors.affiliation: Department of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany. Electronic address: tsaritas@ukaachen.de.
authors.forename: Turgay
authors.initials: T
authors.lastname: Saritas
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Antonis
authors.initials: A
authors.lastname: Koutsonas
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Walter
authors.affiliation: Department of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
authors.affiliation: Department of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Krüger
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D007429:Intraocular Pressure / Q000187:drug effects*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006435:Renal Dialysis; D013549:Sweetening Agents / Q000008:administration & dosage
chemical_list: D013549:Sweetening Agents; D005947:Glucose
keywords: Hemodialysis; blood glucose; diabetes mellitus; eye; intraocular pressure