Effect of hemodialysis on intraocular pressure and ocular perfusion pressure in end-stage renal disease patients admitted at a tertiary care hospital:  A hospital-based comparative observational study.

Dr. P. Sarat  Jyotsna; Dr. Boddepalli Nagendra  Naidu; Dr. Chatti  Ramakrishna

doi:10.51168/sjhrafrica.v7i2.2641

Authors

Dr. P. Sarat Jyotsna Associate Professor, Department of Nephrology, Dr YSR Kidney Research Centre and Super Speciality Hospital, Palasa, Andhra Pradesh, India.
Dr. Boddepalli Nagendra Naidu Associate Professor, Department of Community, Medicine, Government Medical College, Srikakulam, Andhra Pradesh, India.
Dr. Chatti Ramakrishna Assistant Professor, Department of Ophthalmology, Government Medical College, Srikakulam, Andhra Pradesh, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i2.2641

Keywords:

End-stage renal disease, Hemodialysis, Intraocular pressure, Ocular perfusion pressure, Glaucoma, Ultrafiltration

Abstract

Background

Hemodialysis produces rapid osmotic, fluid-volume and systemic hemodynamic changes that may influence intraocular pressure (IOP) and ocular perfusion pressure (OPP) in end-stage renal disease (ESRD).

Objectives

To evaluate the effect of hemodialysis on IOP and OPP among ESRD patients and compare these changes with age- and gender-matched controls.

Methods

This hospital-based comparative observational study was conducted at Dr YSR Kidney Research Centre and Super Speciality Hospital, Palasa, from October 2025 to March 2026. It included 50 ESRD patients undergoing hemodialysis and 50 controls. IOP, systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP) and OPP were assessed before and after hemodialysis in cases and across a corresponding observation period in controls.

Results

The mean age was 53.2 ± 10.8 years in cases and 52.4 ± 10.2 years in controls; males constituted 64.0% and 60.0%, respectively. Diabetes mellitus (44.0% vs 16.0%) and hypertension (78.0% vs 20.0%) were more frequent among cases. Mean average IOP decreased from 16.9 ± 3.0 to 14.9 ± 2.6 mmHg, MAP from 103.2 ± 10.3 to 90.1 ± 9.6 mmHg, and OPP from 51.9 ± 7.4 to 45.2 ± 7.1 mmHg. An OPP reduction of at least 5 mmHg occurred in 68.0% of cases compared with 10.0% of controls.

Conclusion

Hemodialysis was associated with significant reductions in IOP and OPP. OPP reduction appeared mainly related to intradialytic systemic blood pressure decline.

Recommendations

Baseline ophthalmic screening and intradialytic blood pressure surveillance are advisable in high-risk ESRD patients.

Author Biographies

Dr. P. Sarat Jyotsna, Associate Professor, Department of Nephrology, Dr YSR Kidney Research Centre and Super Speciality Hospital, Palasa, Andhra Pradesh, India.

is an Associate Professor in the Department of Nephrology at Dr YSR Kidney Research Centre and Super Speciality Hospital, Palasa, Andhra Pradesh, India. Her academic and clinical work focuses on nephrology, dialysis care, chronic kidney disease, and complications related to end-stage renal disease. She has contributed to patient care, teaching, and clinical research in renal medicine.

Dr. Boddepalli Nagendra Naidu, Associate Professor, Department of Community, Medicine, Government Medical College, Srikakulam, Andhra Pradesh, India.

is an Associate Professor in the Department of Community Medicine at Government Medical College, Srikakulam, Andhra Pradesh, India. His areas of interest include epidemiology, public health research, biostatistics, observational study design, preventive medicine, and community-based health assessment. He has contributed to academic teaching, research methodology, and medical research supervision. ORCID iD: https://orcid.org/0009-0007-3979-3553

Dr. Chatti Ramakrishna, Assistant Professor, Department of Ophthalmology, Government Medical College, Srikakulam, Andhra Pradesh, India.

is an Assistant Professor in the Department of Ophthalmology at Government Medical College, Srikakulam, Andhra Pradesh, India. His clinical and academic interests include ocular pressure assessment, glaucoma-related evaluation, retinal health, and ophthalmic manifestations of systemic diseases. He is involved in undergraduate teaching, patient care, and clinical ophthalmology research.

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