Purpose The aim of this study was to assess the effect of chronic kidney disease and duration of hemodialysis on the corneal endothelium. Patients and methods This case-control study included 78 participants who were divided into three groups: group I: the dialyzed group, group II: the nondialyzed group, and group III: age-matched control group. The endothelial cell density (ECD), average area of endothelial cells, SD, coefficient of variation, percentage of hexagonal cells, and central corneal thickness (CCT) were compared between the three groups. The effect of blood urea, serum creatinine, and duration of dialysis on corneal endothelium was studied in the dialyzed group. Results The ECD was statistically significantly less in the dialyzed group compared with the nondialyzed and control groups (2345.19±307.34, 2428.46±349.38, and 2481.23±286.16 cells/mm 2, respectively, P<0.001). In addition, the percentage of hexagonal cells was significantly less in the dialyzed group compared with the nondialyzed and control groups (41.27±9.73, 69.42±6.16, and 68.54±5.58%, respectively, P<0.001). Meanwhile, the following parameters were significantly higher in the dialyzed group than the nondialyzed and control groups: average area of endothelial cells area (434.23±63.20, 420±66.98, and 408.08±48.80 μm 2, respectively, P<0.001), SD (170.96±48.19, 127±36.18, and 117±20.56, respectively, P<0.001), and coefficient variation of size (39.35±7.52, 31.88±7.07, and 30.54±5.82%, respectively, P<0.001). There was no statistically significant difference in the CCT between the three groups (536.19±55.24, 543.42±37.80, and 539.85±38.44 μm, respectively, P=0.84). A significant negative correlation was found between ECD and the blood urea (P=0.005) and creatinine levels (P=0.03), while the correlation with coefficient variation of size, hexagonality, and CCT was not statistically significant. Conclusion Patients with chronic kidney disease have endothelial cell changes that may compromise the results of intraocular surgery. Awareness among physicians about these changes may help better planning of intraocular surgeries when needed.
