CHRONIC KIDNEY DISEASE

HYPERTENSIVE AND DIABETIC RETINOPATHY IN PATIENTS

Abstract

Diabetes Mellitus and Hypertension are leading causes of chronic kidney
disease (CKD). There is limited data on frequency of retinopathy attributed to diabetes mellitus
or hypertension in CKD patients in local population. Objective: to determine the frequency of
diabetic and hypertensive retinopathy in patients with CKD not on hemodialysis or peritoneal
dialysis. Study Design: Cross Sectional. Setting: Nephorology ward at Sharif Medical City
Hospital. Period: 6 Month. Methods: All patients between ages of 20-80 years with CKD not
previously on renal replacement therapy (hemodialysis or peritoneal dialysis) who were admitted
to nephrology ward at tertiary care facility over a 6 month period were included. Fundoscopic
examination was performed by a qualified ophthalmologist after dilating pupils. Results: A total
of 124 patients were included in the study. Stage V CKD was present in 85.7%. Diabetes Mellitus
was present in 84 patients (67.7%). Of these patients, 39 (46.4%) had diabetic retinopathy. Nonproliferative
diabetic retinopathy, proliferative diabetic retinopathy and macular edema were
found in 27 (69.1%), 4 (10.2%) and 9 (23.1%) patients respectively. Hypertensive retinopathy
was present in 51 (49.5%) out of 103 (83%) hypertensive patients. Of these patients, 16 (31.3%)
had grade I, 21 (41.2%) had grade II, 11 (21.6%) had grade III and 3 (5.8%) had grade IV
hypertensive retinopathy. Conclusion: A significant proportion of patients with advanced CKD
have retinopathy. Patients with CKD and diabetes or hypertension should be encouraged to
undergo a complete eye examination