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| Effects of Hemodialysis and Peritoneal Dialysis on Macular Blood Flow Density and Morphology in Patients with Non-diabetic Nephropathy |
| CHENG Quan, et al |
| The Second Affiliated Hospital of Kunming Medical University, Yunnan Kunming 650000, China |
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Abstract Objective: To explore the effects of hemodialysis and peritoneal dialysis on macular blood flow density and morphology in patients with non-diabetic nephropathy (NDN). Methods: A total of 132 patients with NDN who needed to be treated with dialysis and admitted to the hospital between January 2020 and March 2021 were selected. According to the dialysis modality, they were divided into hemodialysis group (65 cases) and peritoneal dialysis group (67 cases). The levels of hemoglobin (Hb), serum albumin (SAB), serum creatinine (Scr), blood urea nitrogen (BUN), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were detected and compared between the two groups before and after dialysis. The range of 6 mm×6 mm macular area was analyzed by optical coherence tomography angiography (OCTA). The blood flow density of retinal surface, middle and deep capillary plexus, blood flow density of FD300, area and circumference of central macular foveal avascular zone (FAZ), A-circularity index (AI), and the occurrence of complications in the two groups were examined. Results: ①There was no statistically significant difference in Hb, SAB, Scr, and BUN between the two groups before dialysis (P>0.05). After dialysis, Hb and SAB in the two groups were higher than those before dialysis (P<0.05), Scr and BUN were lower than those before dialysis (P<0.05). The differences of Hb and SAB before and after dialysis in the peritoneal dialysis group were lower than those in the hemodialysis group (P>0.05). The differences of Scr and BUN were higher than those in the hemodialysis group (P<0.05). ②There was no statistically significant difference in IL-6 and hs-CRP between the two groups before dialysis (P>0.05). After dialysis, IL-6 and hs-CRP in the two groups were lower than those before dialysis (P<0.05), and the differences in peritoneal dialysis group were lower than those in the hemodialysis group (P<0.05). ③There was no statistically significant difference in blood flow densities of the inner retina surface layer, middle layer, deep layer and FD300 between the two groups before dialysis (P<0.05). After dialysis, the blood flow densities in the two groups were higher than those before dialysis (P<0.05), and the differences in peritoneal dialysis group were lower than those in the hemodialysis group (P<0.05). ④There was no statistically significant difference in area and circumference of FAZ, and AI between the two groups before dialysis (P>0.05). The area and circumference of FAZ, and AI in the hemodialysis group showed no statistically significant difference before and after dialysis (P>0.05). After dialysis, the circumference of FAZ in the peritoneal dialysis group was smaller than that before dialysis (P<0.05), and AI was higher than that before dialysis (P<0.05). The differences of area and circumference of FAZ, and AI before and after dialysis in the peritoneal dialysis group were higher than those in the hemodialysis group (P<0.05). ⑤The incidence of fever in peritoneal dialysis group was significantly lower than that in hemodialysis group (P<0.05). However, there was no significant difference in the incidence rates of hypotension, hypoglycemia, peritonitis and cerebral edema, and fatality rate between the two groups (P>0.05). Conclusion: For patients with non-diabetic nephropathy, both hemodialysis and peritoneal dialysis can effectively improve their nutritional status. Compared with hemodialysis, peritoneal dialysis can better improve renal function and reduce blood density of retinal middle and deep layers. However, it induces more inflammatory factorsand increases AI. Clinically, the dialysis plan should be determined after comprehensive consideration.
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2022, Vol. 28 
