Day 1 :
Central University of Ecuador, Ecuador
Keynote: Ocular disorders detected in end stage renal disease undergoing hemodialysis patients and laboratorial correlations
Time : 10:00-10:40
Dario Xavier Jimenez Acosta MD. Nephrologist Born in 1977, October 03. Medical Doctor at Central University of Ecuador (1994-2001). Nephrologist by Pichincha Medical College, at Eugenio Espejo Specialty Hospital (2002-2007). Did Nephrology mini fellowship at Colorado University, Denver (2007).He is the Past Secretary of Ecuadorian Society of Nephrology (2012-2015), Medical Director of DIALNEF (Critical Nephrology) Quito-Ecuador (2012-actually). Nephrology Chief at Enrique Grace’s General Hospital (Ecuadorian Health Public Ministry). One book published (coauthor), 16 paper published.
The eye disorders and the ocular fundus in CKD stage 5 patients have been little studied, with no literature available in our country. The uremic state of these patients due to systemic diseases or kidney own diseases produces eye affectations. Objective: To document the prevalence of ocular abnormalities in ERC5 patients and laboratorial correlation. Materials and Methods: A comprehensive optometric examination was realized to 105 patients with CKD 5 in hemodialysis(HD) and fundus eye a significant sample (n 50). Variables such as: distance visual acuity (AVL) and close (AVP), external examination, slit lamp and fundus photograph of the posterior pole were performed. Results: 55 patients were male (52%) and 50 women (48%), aged between 18 and 91 years (mean 49 yo). 70% (n73) achieved acceptable vision and 5% (n5) had 20/200 or less vision. The cataract was observed in 30% (n31) dry eyes 28% (n29), pterygium28% (n29) and hyperemia 22% (n23) of cases. Laboratorial correlations were performed with seric calcium, phosphorus and parathyroid hormone (PTH). There was no statistically significant difference between the groups with and without cataract for PTH levels in both diabetics (p = 0.98) and non-diabetics (p = 0.79). However the hypocalcemia seems to have a strong correlation with cataract, and the triad Hypercalcemia, hyperparathyroidism and hyperphosphatemia a high correlation with other ocular disorders. 213 photographs were taken and analyzed 100 photographs, 6% of patients (n3) showed bilateral Normal Fundus. Hypertensive retinopathy was found (32%), abnormalities we have found them as typical of the ESRD (24%) were present in 79% of patients who had glomerulopathies. Conclusions: The final results showed high incidence of eye disease in ESRD patients. 6% of 50 patients tested had normal eye Fund bilateral. This shows the great importance of a comprehensive optometric examination and eye fundus in this group of patients and the possible presence of uremic retinopathy as own nosological entity of these patients.