Introduction:
Patients with Chronic Kidney disease(CKD) are susceptible to dry eye. This constitutes about 15-20% of eye-related complications with attendant effect on morbidity, quality of life and multiple visits to ophthalmic clinic. Despite this, there is paucity of studies on tear film production among the CKD population. The purpose of this study is to explore the pattern of tear film production among patients with chronic kidney seen in four tertiary health institutions in Southern Nigeria and obtain the risk factors for dry eyes.
Methods:
This is a cross-sectional multi- center study in four tertiary hospitals among patients aged 16-65 years with chronic kidney disease stages I-V (including dialytic patients) over a two-year period. Patients with previous eye surgeries and post transplant patients were excluded. Socio-demographic and clinical variables were extracted using an interviewer-administered questionnaire in a consecutive patient recruitment pattern . Schimer 1 and ocular surface disease index (OSDI) questionnaire were administered to assess tear volume production in each eye. The outcome variable was dry eyes. Tables and charts were used to display data. Binary logistic regression was used to obtain the independent risk factors for dry eyes among the patient. All p-value less than 0.05 were regarded as statistically significant.
Results:
There were 364 patients with different stages of CKD. There were more males (60%), predominantly traders (40%) and middle age group (35%). The prevalence of dry eyes is 17%. The mean tear volume of patients with stage I and II CKD (26.5±3.5mm) were higher than that of patients with stages III-V CKD (16.4±2.8mm) for both eyes. The difference is statistically significant (t=5.5, p=0.001). The mean OSDI values of patients with stage I and II CKD (29.5±4.5) were higher than that of patients with stages III-IV CKD (17.8±5.3). The difference was statistically significant (t=11.8. p=0.003). There was no statistical difference between patient on dialysis and those not on dialysis. Binary logistic regression analysis showed that stage III-V and Diabetes as a cause of CKD were independent risk factors of reduced tear volume with adjusted odd’s ratio of 2.3 and 5.2 respectively.
Conclusions:
Dry eyes as an eye-related complication was found in a good number of the patients, mainly in later stages of CKD with risk factors including CKD stages III-V and diabetes-related CKD. There is need for more studies on eye-related complications and to encourage regular ophthalmic examination among patients with CKD to avoid irremediable complications of eye disease.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.