Tear Gland Function Affected by Kidney Transplant

Study found age, smoking and other factors significantly influence the development of dry eye.

Factors for dry eye disease (DED) in patients preparing to receive a kidney include age group, smoking history, corneal central thickness, and conjunctival calcification, reinforcing the existing evidence for multifactorial DED in those with renal impairment, according to findings published in Clinical Ophthalmology.

Researchers conducted a study to explore the relationship between DED and factors that influence the susceptibility to DED in patients with end-stage renal failure. The study included 89 kidney recipients and 57 kidney donors, and the groups were matched for age and sex. The main outcome measure was dry eye, confirmed by Schirmer testing. The association was evaluated using tear breakup time (TBUT) and the Ocular Surface Disease Index (OSDI).

The study found that age group, and no other factor, was statistically significant when univariate analysis found the level of visual acuity (VA) (P <.05). Additionally, age, smoking history (P <.05), corneal conjunctival calcification (P <.05), and central corneal thickness (P <.05) were considered to be influence factors for disease progression in multivariable logistic regression analysis.

The researchers explain that “this phenomenon is due to the decline in the endocrine, leading to disorders of the accessory tear glands,” and that renal failure itself also perpetuates the degree of damage to the tear glands.

Regarding the observed correlation between DED and corneal calcification, the researchers explain that its significance in the current study was likely due to the tendency of calcium deposition to induce inflammatory responses and increase tear permeability. They further note that, though this outcome was also seen in previous research, it is contrary to some other findings which found no relationship between conjunctival calcification and DED, noting that “this difference is probably due to different criteria for evaluating dry eyes.”

The researchers also note that the current study’s findings may provide guidelines for the future treatment of DED in this population. Study limitations include possible confounding due to factors inherent to the design of case-control studies, such as repeat errors and retroactive elements.


Le Trung N, Quoc Toan P, Thang LV, et al. The relationship between dry eye in adults with indications for kidney transplantation and influence factors. Clin Ophthalmol. 2021;15(10):4327-4332. doi:10.2147/OPTH.S335989