Ultrafiltration rate in hemodialysis does not affect mean ocular perfusion pressure or intraocular pressure in end‐stage renal disease

• Published in: Acta ophthalmologica (Oxford, England) England), 2016-10, Vol.94 (S256), p.n/a
• Main Authors: Leal, I., Cordeiro Sousa, D., Couceiro, R., Bigotte Vieira, M., Noélia, L., Resina, C., Neves, F., Gomes da Costa, A., Pinto, F., Marques‐Neves, C., Proença, H.
• Format: Article
• Language: English
• Subjects: Cardiovascular diseases; End-stage renal disease; Eye; Health risks; Hemodialysis; Intraocular pressure; Ischemia; Kidney diseases; Kidney transplantation; Medicare; Ophthalmology; Perfusion; Pressure; Risk factors; Statistical analysis; Ultrafiltration
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2016.0495

Purpose Ultrafiltration rate (UFR), the rate at which fluid is removed during hemodialysis (HD), has been increasingly recognized as a potential modifiable cardiovascular risk factor in HD patients. High UFR has been shown to promote non‐physiological fluid shifts and hemodynamic instability, which may contribute to tissue ischemia. Our goal was to evaluate if changes in mean ocular pressure perfusion (MOPP) and intraocular pressure (IOP) could be related to UFR. Methods Prospective cohort study including 16 eyes of 16 black patients (8 women) with end‐stage renal disease (ESRD) under HD. Haemodynamic data and IOP (measured with Tonopen®) were obtained 1 h before and after HD. MOPP was calculated as MOPP = 2/3(MAP) − IOP. STATA v.13.0 was used as statistical package and a p‐value of 0.05 was considered statistically significant. Results Mean age of ESRD patients was 46.81 ± 7.72 [range 28–60] years. The mean time under HD was 17.38 ± 14.67 months. MOPP before and after HD were 52.7 ± 13.0 and 51.4 ± 13.1 mmHg, respectively. The difference between MOPP before and after HD was not statistically significant (p = 0.15). UFR applied to these patients was 673.6 ± 198.7 [range 250–1000] ml/h. When applying a regression model, this difference in MOPP was not associated with the UFR (p = 0.56), in both crude and adjusted analysis. Conclusions In patients with ESRD, changes in MOPP do not seem to be related with UFR. Although UFR has been claimed to be culprit of tissue ischemia, still ill‐defined vaso and barorregulatory mechanisms may play a role in protecting the eye from ischemia during this hemodynamic challenge.