alexa Increase Intraocular Pressure (IOP) During Hemodialysis, Rare Condition: Serious Complication | 43725
ISSN: 2161-0959

Journal of Nephrology & Therapeutics
Open Access

Like us on:

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations
700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

6th Annual conference on Clinical & Pediatric Nephrology

Rula Abdurrahman, Anthony Iluyomade, Denish Pokharel and Rajbir Chopra
St. John’s Episcopal Hospital, USA
Posters & Accepted Abstracts: J Nephrol Ther
DOI: 10.4172/2161-0959.C1.025
Abstract
Introduction: For years, so many complications of hemodialysis have been well documented. However, elevated intraocular pressure (IOP) from HD is an extremely rare finding. In fact, this has led to eyeball evisceration in some cases that were refractory to treatment modalities. Case: A 53 years old man with hypertension, DM and ESRD on hemodialysis presented to the ER with shortness of breath and edema. He reported failing to complete four sessions of dialysis due to headache and eye pain. The patient mentioned that during the dialysis he was having headache 9/10, which was relieved few hours after stopping dialysis sessions. Pain was associated with nausea and blurry vision. He denied any previous history of laser eye surgery or glaucoma but has had bilateral cataract surgery within the past year. On examination, patient had generalized edema. Vitals were BP: 170/90, Temp: 96.9F, PR: 70 and RR: 20. Lab findings; WBC: 12000, Hemoglobin: 9.8, Platelets: 219000, K=6.5, BUN=92, Creatinine=12.40, Calcium: 10.4, Pro BNP=5760 and EGFR: 5.18. CT head was unremarkable. Urgent hemodialysis was initiated, during which patient became confused and agitated. He started complaining of bilateral eye pain with occipital headache. This prompted for ophthalmology consult. Measured IOP was 38 (right) and 34 (left) mmHg. Optic cups showed temporal pallor in both eyes. Gonioscopy revealed pigment dispersion in the right eye in the trabecular meshwork (part of the aqueous humor drainage system of the eye). Left eye anterior chamber showed no pigment deposition. IOP dropped down to 24 OD (right eye) and 22 OS (left eye) one hour after commencing Alphagan 0.15%, Xalatan and Timolol 0.5% OU with further drop in IOP to 18 bilaterally in two hours. Diamox 500 mg PO TID was also added. After few days of treatment, he was able to tolerate hemodialysis with no more eye pain or headache. Discussion: Few publications have cited the possibility of hemodialysis leading to elevated IOP especially in susceptible eyes as seen in our patient. However, the pigment deposition (that might be a complication of cataract surgery) was not observed on the left eye. This suggests the possibility of hemodialysis leading to elevated IOP even in a non-susceptible eye. This may happen due to the rapid decrease in serum osmolality leading to shift of fluid from plasma to the aqueous humor as a result of osmotic disequilibrium. Our patient had some occlusions of his trabecular meshwork in the right eye, which could explain the development of his symptoms recently, despite been on hemodialysis for years. Acetazolamide has been used with precautions of metabolic acidosis.
Biography

Rula Abdurrahman is a graduate from the University of Baghdad, School of Medicine, pursued an expansive medical career and research overseas and is currently a PGY2 Internal Medicine Resident at St. John’s Episcopal Hospital in Far rockaway, New York. She has worked as Case Manager and Clinical Supervisor in the Italian Red Cross to help the war victims in the Middle East in 2003. She is currently following a path of clinical research with multiple abstracts and case presentations while serving as a Resident Physician.

Email: [email protected]

image PDF   |   image HTML
 

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

+1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
Leave Your Message 24x7