Universität zu Köln

Dufek, Stephanie ORCID: 0000-0002-6323-6673, Feldkoetter, Markus, Vidal, Enrico ORCID: 0000-0003-3963-0803, Litwin, Mieczyslaw ORCID: 0000-0002-5241-2483, Munk, Marion, Reitner, Andreas, Mueller-Sacherer, Thomas, Aufricht, Christoph, Arbeiter, Klaus and Boehm, Michael (2014). Anterior ischemic optic neuropathy in pediatric peritoneal dialysis: risk factors and therapy. Pediatr. Nephrol., 29 (7). S. 1249 - 1258. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

Sudden blindness caused by anterior ischemic optic neuropathy (AION) is a rare complication for patients undergoing peritoneal dialysis (PD). Prognosis is generally poor, with AION commonly resulting in permanent visual loss. We first describe four case reports of children with AION during PD treatment. We then review ten additional AION cases reported in the literature and compare these 14 affected patients with a control cohort of 59 non-affected patients in the Vienna PD registry. Significant risk factors for AION were identified as median age (4 vs. 27 months; p < 0.001), autosomal recessive polycystic kidney disease (28.6 vs. 3.4 %; p = 0.01), anephric status (53.8 vs. 6.8 %; p < 0.001) and low to normal blood pressure evidenced by the number of patients having to be treated with antihypertensive medications (14.3 vs. 62.7 %; p = 0.01). Severe hypovolemia was reported in 50 % of all cases. Outcome was visual loss with optic atrophy in nine patients; five patients had a good visual outcome. The major difference in treatment was a rapid bolus of saline within 12 h after the initial symptoms. Young age, autosomal recessive polycystic kidney disease, anephric status and hypotension are substantial risk factors for AION. Early hospitalization with vascular refilling within a few hours following onset of blindness leads to improved visual outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dufek, Stephanie UNSPECIFIED orcid.org/0000-0002-6323-6673 UNSPECIFIED Feldkoetter, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Vidal, Enrico UNSPECIFIED orcid.org/0000-0003-3963-0803 UNSPECIFIED Litwin, Mieczyslaw UNSPECIFIED orcid.org/0000-0002-5241-2483 UNSPECIFIED Munk, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Reitner, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Sacherer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Aufricht, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Arbeiter, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehm, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-435558
DOI:	10.1007/s00467-013-2747-6
Journal or Publication Title:	Pediatr. Nephrol.
Volume:	29
Number:	7
Page Range:	S. 1249 - 1258
Date:	2014
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-198X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NOCTURNAL ARTERIAL-HYPOTENSION; POLYCYSTIC KIDNEY-DISEASE; NERVE HEAD; CHILDREN Multiple languages Pediatrics; Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43555