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Ocular and systemic factors associated with glaucoma in chronic kidney disease patients

  • Nephrology - Original Paper
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Abstract

The goal of this study was to examine, the relationship between chronic kidney disease (CKD) and glaucomatous optic disc neuropathy in a cohort of patients from the south-east Serbia and to determine whether limited screening for glaucoma in specific subgroups of patients with CKD is reasonable and justifiable. This cross-sectional study included 328 subjects with various stages of CKD. All patients had visited the Outpatient Department of the Nephrology Clinic, Clinical Center Nis, Serbia. All patients underwent routine ophthalmic examinations. Glaucoma diagnosis based on elevated intraocular pressure (IOP), the presence of excavation of the optic nerve head (C/D ratio), and characteristic glaucomatous visual field loss (MD—mean deviation, PSD—pattern standard deviation). CKD was defined as kidney damage or glomerular filtration rate (GFR) of <60 ml/min/1.73 m2 for >3 months. A total number of 328 CKD patients, 33 (10.1 %) with primary open angle glaucoma and 28 (8.5 %) with ocular hypertension (OH), were included in the study. Patients with CKD and glaucoma had significantly higher mean values of C/D ratio (0.59), visual field mean deviations (dB)—MD (p < 0.001), and visual field pattern standard deviations (dB)—PSD (p < 0.001) than patients with CKD and OH. Stepwise multivariate linear regression analysis confirmed that the most significant factors related to IOP are age (p < 0.05), AHT (p = 0.01), and eGFR (p = 0.001). Multivariate regression analysis also confirmed that the most significant factors related to cup-to-disc ratio are number of years of smoking (p < 0.05), AHT, and sCr (p < 0.01). In conclusion, the prevalence of glaucoma among CKD patients in the cohort from south-east Serbia is 10.1 %. Patients with CKD and glaucoma, eGFR and current cigarette smoking are associated with IOP level, MD, and PSD of visual field and C/D ratio.

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Acknowledgments

This work was supported by a Grant No 175092 from the Ministry of Education, Science and Technological Development of Serbia.

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Authors and Affiliations

  1. Clinic of Ophthalmology, Faculty of Medicine, University of Nis, Nis, Serbia

    Jasmina Djordjevic-Jocic, Predrag Jovanovic, Aleksandar Veselinovic & Maja Zivkovic

  2. Clinic of Nephrology, Faculty of Medicine, University of Nis, Nis, Serbia

    Rade Cukuranovic, Branka Mitic & Slavimir Veljkovic

  3. Faculty of Medicine, Institute of Biochemistry, University of Nis, Nis, Serbia

    Vidosava Djordjevic

  4. State University of Novi Pazar, Novi Pazar, Serbia

    Dragan Bogdanovic

  5. Research Department, Faculty of Medicine, University of Nis, Blvd. Zorana Djindjica 81, 18000, Nis, Serbia

    Marija Mihajlovic & Vladisav Stefanovic

Authors
  1. Jasmina Djordjevic-Jocic
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  2. Rade Cukuranovic
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  3. Branka Mitic
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  4. Predrag Jovanovic
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  5. Vidosava Djordjevic
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  7. Aleksandar Veselinovic
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  9. Slavimir Veljkovic
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  10. Dragan Bogdanovic
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  11. Vladisav Stefanovic
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Correspondence to Vladisav Stefanovic.

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Djordjevic-Jocic, J., Cukuranovic, R., Mitic, B. et al. Ocular and systemic factors associated with glaucoma in chronic kidney disease patients. Int Urol Nephrol 46, 2191–2198 (2014). https://doi.org/10.1007/s11255-014-0804-0

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  • DOI: https://doi.org/10.1007/s11255-014-0804-0

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