Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study

Background Ocular disorders can arise in the advanced stages of chronic kidney disease (CKD) for various reasons, including uraemia, biochemical abnormalities, hypertension and inadequate haemodialysis treatment.Methods We conducted a cross-sectional study at the Pediatric Nephrology Department, bot...

Full description

Saved in:
Bibliographic Details
Main Authors: Abdullah Al Mamun, Afroza Begum, Mohammad Azmain Iktidar, Faisal Chowdhury, Amit Kumar Datta, Ranjit Ranjan Roy, Tahmina Jesmin, Mohammad Afzal Mahfuzullah
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/8/1/e002777.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846156417746075648
author Abdullah Al Mamun
Afroza Begum
Mohammad Azmain Iktidar
Faisal Chowdhury
Amit Kumar Datta
Ranjit Ranjan Roy
Tahmina Jesmin
Mohammad Afzal Mahfuzullah
author_facet Abdullah Al Mamun
Afroza Begum
Mohammad Azmain Iktidar
Faisal Chowdhury
Amit Kumar Datta
Ranjit Ranjan Roy
Tahmina Jesmin
Mohammad Afzal Mahfuzullah
author_sort Abdullah Al Mamun
collection DOAJ
description Background Ocular disorders can arise in the advanced stages of chronic kidney disease (CKD) for various reasons, including uraemia, biochemical abnormalities, hypertension and inadequate haemodialysis treatment.Methods We conducted a cross-sectional study at the Pediatric Nephrology Department, both inpatient and outpatient, of from January 2020 to July 2021. The study aimed to identify and compare ophthalmological changes among children at different stages of CKD to assess potential visual threats. A total of 92 children with advanced-stage CKD, aged 5–18 years, meeting the inclusion and exclusion criteria, were included in the study. Comprehensive assessments, including medical history, physical examinations, relevant tests and detailed ophthalmological examinations, were conducted.Results The mean age of the participants was 12.1±3.68 years. Most of the children were boys (66%). Twenty-nine patients exhibited impaired visual acuity, children with (6/60–6/24) scores in Snellen’s chart Lid oedema and conjunctival pallor were observed in 20.7% and 60.9% of cases, respectively, which were found to statistically significant with advancing CKD stages (p<0.001). Dry eyes were found in 9.8% of CKD stage V patients receiving dialysis (VD) (p=0.003). One patient had a posterior subcapsular cataract, and 7.6% had conjunctival congestion. Patients with conjunctival congestion and hypertensive retinopathy had significantly higher levels of serum phosphate and calcium phosphate product (p<0.001). Hypertensive retinopathy was present in 16.3% of cases, with a significantly higher proportion in the haemodialysis group (93%). Haemodialysis patients exhibited higher blood pressure, lower haemoglobin levels, and a more severe reduction in estimated glomerular filtration rate (p<0.001).Conclusion This study highlights the significant ocular complications associated with CKD, underscoring the need for regular ophthalmological screenings.
format Article
id doaj-art-d4112aab632f47b1a7c9a3407ef5baa3
institution Kabale University
issn 2399-9772
language English
publishDate 2024-11-01
publisher BMJ Publishing Group
record_format Article
series BMJ Paediatrics Open
spelling doaj-art-d4112aab632f47b1a7c9a3407ef5baa32024-11-26T06:25:13ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722024-11-018110.1136/bmjpo-2024-002777Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based studyAbdullah Al Mamun0Afroza Begum1Mohammad Azmain Iktidar2Faisal Chowdhury3Amit Kumar Datta4Ranjit Ranjan Roy5Tahmina Jesmin6Mohammad Afzal Mahfuzullah7School of Population Health, The University of Queensland, Herston, Queensland, Australiaresearch assistantDirectorate General of Health Services, Dhaka, BangladeshDepartment of Medicine, Chittagong Medical College Hospital, Chittagong, BangladeshBangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshBangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshBangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshBangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshBackground Ocular disorders can arise in the advanced stages of chronic kidney disease (CKD) for various reasons, including uraemia, biochemical abnormalities, hypertension and inadequate haemodialysis treatment.Methods We conducted a cross-sectional study at the Pediatric Nephrology Department, both inpatient and outpatient, of from January 2020 to July 2021. The study aimed to identify and compare ophthalmological changes among children at different stages of CKD to assess potential visual threats. A total of 92 children with advanced-stage CKD, aged 5–18 years, meeting the inclusion and exclusion criteria, were included in the study. Comprehensive assessments, including medical history, physical examinations, relevant tests and detailed ophthalmological examinations, were conducted.Results The mean age of the participants was 12.1±3.68 years. Most of the children were boys (66%). Twenty-nine patients exhibited impaired visual acuity, children with (6/60–6/24) scores in Snellen’s chart Lid oedema and conjunctival pallor were observed in 20.7% and 60.9% of cases, respectively, which were found to statistically significant with advancing CKD stages (p<0.001). Dry eyes were found in 9.8% of CKD stage V patients receiving dialysis (VD) (p=0.003). One patient had a posterior subcapsular cataract, and 7.6% had conjunctival congestion. Patients with conjunctival congestion and hypertensive retinopathy had significantly higher levels of serum phosphate and calcium phosphate product (p<0.001). Hypertensive retinopathy was present in 16.3% of cases, with a significantly higher proportion in the haemodialysis group (93%). Haemodialysis patients exhibited higher blood pressure, lower haemoglobin levels, and a more severe reduction in estimated glomerular filtration rate (p<0.001).Conclusion This study highlights the significant ocular complications associated with CKD, underscoring the need for regular ophthalmological screenings.https://bmjpaedsopen.bmj.com/content/8/1/e002777.full
spellingShingle Abdullah Al Mamun
Afroza Begum
Mohammad Azmain Iktidar
Faisal Chowdhury
Amit Kumar Datta
Ranjit Ranjan Roy
Tahmina Jesmin
Mohammad Afzal Mahfuzullah
Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study
BMJ Paediatrics Open
title Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study
title_full Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study
title_fullStr Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study
title_full_unstemmed Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study
title_short Ophthalmological changes in children with advanced stage of chronic kidney disease: a hospital-based study
title_sort ophthalmological changes in children with advanced stage of chronic kidney disease a hospital based study
url https://bmjpaedsopen.bmj.com/content/8/1/e002777.full
work_keys_str_mv AT abdullahalmamun ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT afrozabegum ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT mohammadazmainiktidar ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT faisalchowdhury ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT amitkumardatta ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT ranjitranjanroy ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT tahminajesmin ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy
AT mohammadafzalmahfuzullah ophthalmologicalchangesinchildrenwithadvancedstageofchronickidneydiseaseahospitalbasedstudy