Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis

Introduction. Kidney and pancreas transplantation is a surgical method for the treatment of patients with diabetes mellitus and terminal diabetic nephropathy. While waiting for surgical treatment, potential recipients receive maintenance hemodialysis. Dialysis initiates the loss of body fluid, which...

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Main Authors: I. V. Vorobyeva, E. V. Bulava, A. G. Balkarov, I. V. Dmitriev
Format: Article
Language:English
Published: N.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare Department 2023-06-01
Series:Трансплантология (Москва)
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Online Access:https://www.jtransplantologiya.ru/jour/article/view/773
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author I. V. Vorobyeva
E. V. Bulava
A. G. Balkarov
I. V. Dmitriev
author_facet I. V. Vorobyeva
E. V. Bulava
A. G. Balkarov
I. V. Dmitriev
author_sort I. V. Vorobyeva
collection DOAJ
description Introduction. Kidney and pancreas transplantation is a surgical method for the treatment of patients with diabetes mellitus and terminal diabetic nephropathy. While waiting for surgical treatment, potential recipients receive maintenance hemodialysis. Dialysis initiates the loss of body fluid, which in turn can affect the state of the intraocular structures. Aim. To study the effect of long-term hemodialysis therapy on ophthalmic parameters in patients with terminal diabetic nephropathy. Material and methods. Sixty patients (120 eyes) were examined: group A included 30 patients with end-stage renal failure as a result of diabetic nephropathy, group B included 30 people without systemic and ocular pathologies. The ophthalmological status of group A was assessed at the stage of planned preparation for renal replacement therapy, at 3 and 6 months after the initiation of dialysis. Ophthalmological examination consisted of the use of traditional and special diagnostic methods (microperimetry, photorecording of the fundus, optical coherence tomography angiography). Results. Within 6 months of hemodialysis courses, the following was recorded: a decrease in the thickness of the retina (Me: from 348.5 to 306.1 µm; p <0.05) and choroid (Me: from 330.3 to 294.9 µm; p <0.05), the improvement of retinal perfusion in eyes with diabetic macular edema (Me in the superficial capillary plexus: from 10.6 to 15.8% in the fovea, from 19.7 to 25.4% in the parafovea; in the deep capillary plexus: from 15.4 to 20.9% in the fovea, from 27.5 to 33.5% in the parafovea; p <0.05), a decrease in choroidal hemoperfusion (Me in the layer of choriocapillaries: from 59.0 to 54.2% in the fovea, from 59.3 to 54.7% in the parafovea; in the deep layer of the choroids: from 55.5 to 50.7% in the fovea, from 55.3 to 50.7% in the parafovea; p<0.05),an improvement in retinal photosensitivity (Me: from 16.7 to 20.3 dB in eyes with diabetic macular edema; from 21.1 to 24.2 dB in eyes without diabetic macular edema; p<0.05) and increased visual acuity in eyes with macular edema (Me: 0.1 to 0.3; p<0.05). Conclusions. Against the background of maintenance hemodialysis hemodialysis in patients with terminal diabetic nephropathy, along with a decrease in hyperazotemia, there is an improvement in architectonics, hemodynamics of the retina and visual functions.
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spelling doaj-art-cb89bc775108471b8557a960ee9e6cfc2025-08-20T03:56:36ZengN.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare DepartmentТрансплантология (Москва)2074-05062542-09092023-06-0115218819910.23873/2074-0506-2023-15-2-188-199565Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysisI. V. Vorobyeva0E. V. Bulava1A. G. Balkarov2I. V. Dmitriev3Russian Medical Academy of Continuous Professional Education; Peoples’ Friendship University of RussiaRussian Medical Academy of Continuous Professional EducationN.V. Sklifosovsky Research Institute for Emergency Medicine; N.I. Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical ManagementN.V. Sklifosovsky Research Institute for Emergency Medicine; N.I. Pirogov Russian National Research Medical UniversityIntroduction. Kidney and pancreas transplantation is a surgical method for the treatment of patients with diabetes mellitus and terminal diabetic nephropathy. While waiting for surgical treatment, potential recipients receive maintenance hemodialysis. Dialysis initiates the loss of body fluid, which in turn can affect the state of the intraocular structures. Aim. To study the effect of long-term hemodialysis therapy on ophthalmic parameters in patients with terminal diabetic nephropathy. Material and methods. Sixty patients (120 eyes) were examined: group A included 30 patients with end-stage renal failure as a result of diabetic nephropathy, group B included 30 people without systemic and ocular pathologies. The ophthalmological status of group A was assessed at the stage of planned preparation for renal replacement therapy, at 3 and 6 months after the initiation of dialysis. Ophthalmological examination consisted of the use of traditional and special diagnostic methods (microperimetry, photorecording of the fundus, optical coherence tomography angiography). Results. Within 6 months of hemodialysis courses, the following was recorded: a decrease in the thickness of the retina (Me: from 348.5 to 306.1 µm; p <0.05) and choroid (Me: from 330.3 to 294.9 µm; p <0.05), the improvement of retinal perfusion in eyes with diabetic macular edema (Me in the superficial capillary plexus: from 10.6 to 15.8% in the fovea, from 19.7 to 25.4% in the parafovea; in the deep capillary plexus: from 15.4 to 20.9% in the fovea, from 27.5 to 33.5% in the parafovea; p <0.05), a decrease in choroidal hemoperfusion (Me in the layer of choriocapillaries: from 59.0 to 54.2% in the fovea, from 59.3 to 54.7% in the parafovea; in the deep layer of the choroids: from 55.5 to 50.7% in the fovea, from 55.3 to 50.7% in the parafovea; p<0.05),an improvement in retinal photosensitivity (Me: from 16.7 to 20.3 dB in eyes with diabetic macular edema; from 21.1 to 24.2 dB in eyes without diabetic macular edema; p<0.05) and increased visual acuity in eyes with macular edema (Me: 0.1 to 0.3; p<0.05). Conclusions. Against the background of maintenance hemodialysis hemodialysis in patients with terminal diabetic nephropathy, along with a decrease in hyperazotemia, there is an improvement in architectonics, hemodynamics of the retina and visual functions.https://www.jtransplantologiya.ru/jour/article/view/773type 1 diabetes mellitusdiabetic nephropathydiabetic retinopathyhemodialysismicroperimetryoptical coherence tomography angiography
spellingShingle I. V. Vorobyeva
E. V. Bulava
A. G. Balkarov
I. V. Dmitriev
Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
Трансплантология (Москва)
type 1 diabetes mellitus
diabetic nephropathy
diabetic retinopathy
hemodialysis
microperimetry
optical coherence tomography angiography
title Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
title_full Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
title_fullStr Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
title_full_unstemmed Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
title_short Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
title_sort results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis
topic type 1 diabetes mellitus
diabetic nephropathy
diabetic retinopathy
hemodialysis
microperimetry
optical coherence tomography angiography
url https://www.jtransplantologiya.ru/jour/article/view/773
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AT agbalkarov resultsofstudyingthediabeticretinopathycourseinpotentialkidneyandpancreaticrecipientswhileonhemodialysis
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