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- W2131394977 abstract "The response of intraocular pressure (IOP) to hemodialysis was investigated in 55 patients with end-stage kidney disease enrolled in a chronic dialysis program. The mean level of IOP, measured by the Goldmann applanation tonometer, before dialysis was slightly lower than that of a control group of 50 healthy subjects (14.9 ′ 2 mm Hg vs 15.6 ′ 1.9 mm Hg. p =. 07). During dialysis IOP underwent an excessive rise (7.8 to 12.5 mm Hg) in 10 patients (group 1), remained unchanged (variations below 2 mm Hg) in 41 patients (group 2), and decreased (3.1 to 5.1 mm Hg) in 4 patients (group 3). In group 1 patients, gonioscopy showed a narrow angle between iris and lateral cornea. Conversely, the anterior chamber angle was normal in patients of groups 2 and 3. The effect of a 7-day course of acetazolamide therapy (500 mg per day orally) on IOP was investigated in group 1 patients. Acetazolamide was capable of preventing the excessive IOP rise during dialysis. The mean reduction of such a dialytic rise was 8.1 mm Hg. However, despite this effect, in these patients the IOP level after dialysis still remained significantly higher than that of patients of group 2 (18.1 ′ 1 mm Hg vs 14.9 ′ 0.8 mm Hg. p <. 0001). Acetazolamide therapy precipitated in all patients a severe metabolic acidosis (blood pH fell from 7.38 ′ 0.02 to 7.24 ′ 0.03, p <. 0001; and bicarbonate concentration from 21 ′ 2.5 mmol/liter to 12.3 ′ 2.4 mmol/liter, p <. 0001). We conclude that (1) an excessive, and potentially harmful, rise of IOP during dialysis is not a remote possibility in hemodialysis patients; (2) acetazolamide therapy prevents such an excessive dialytic rise but is not capable of normalizing the IOP level after dialysis; (3) the administration of the carbonic anhydrase inhibitor to hemodialysis patients causes a severe metabolic acidosis, probably by interfering with extrarenal buffering systems." @default.
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- W2131394977 date "1989-01-01" @default.
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- W2131394977 title "Intraocular Pressure Changes During Hemodialysis: Prevention of Excessive Dialytic Rise and Development of Severe Metabolic Acidosis Following Acetazolamide Therapy" @default.
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- W2131394977 doi "https://doi.org/10.3109/08860228909066953" @default.
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