Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: a review of literature

Usta, Mehmet; Ayar, Yavuz; Ocakoğlu, Gökhan; Yuzbasioglu, Bilgehan; Erdem, Emrullah; Erdoğan, Ömer

doi:10.1186/s12882-020-02108-w

Cited by 13 publications

(13 citation statements)

References 56 publications

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“…Misra et al [ 18 ] found that GIS abnormalities were more common in patients with CKD in a study that they evaluated the endoscopic findings in patients with CKD and compared them with normal individuals. In terms of gastritis prevalence, Usta et al [ 19 ] determined the frequency of histological gastritis as 62.3% in dialysis patients, Fabian et al [ 20 ] determined the frequency of histological gastritis was 71.5%, Al-Mueilo et al [ 21 ] found the frequency of histological gastritis 51.9% in hemodialysis patients. In our study, the patients were evaluated symptomatically in terms of gastritis and compared according to the RRT modality.…”

Section: Discussionmentioning

confidence: 99%

Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities

Karahan

Şahi̇n

2022

BMC Nephrol

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Objective Chronic kidney disease (CKD) affects gastrointestinal system (GIS) and causes histological, functional and mucosal changes. There are scarce data investigating GIS symptoms and findings in patients with CKD stage III-V, receiving hemodialysis (HD) and peritoneal dialysis (PD). In this study, we aimed to evaluate the frequency of gastrointestinal symptoms and findings and compare between renal replacement therapies. Method A total of 290 patients (97 in CKD stage III-V, 92 PD, 101 HD) were included in this study. Gastrointestinal complaints, diseases, background characteristics of patients and drugs they used were questioned by interviews, forms were filled and examinations of patients were performed. Results of upper GIS endoscopy, colonoscopy, abdominal ultrasonography and tomography of patients were evaluated. Results The most common signs were dyspepsia (50%), nausea (45%) and epigastric pain (44%) among all patients, generally. Gastrointestinal disorders like gastritis (62%) and gastroesophageal reflux (39%) were frequent in patients. Prevalence of patients with weight loss was 20% in predialysis and 8% in PD and the ratio was higher in predialysis group statistically significantly (p = 0,016). The prevalence of gastritis was 70% in PD, 55% in HD and the prevalence of hemorrhoids was 24% in PD and 12% in HD. The prevalence of gastritis and hemorrhoids was higher in the PD group than in the HD group statistically significantly (p = 0.043, p = 0.028), otherwise, there wasn’t a difference between the PD and predialysis groups, statistically significantly. Conclusion This study showed that; gastrointestinal symptoms and disorders were very common in CKD, besides this; while gastritis and hemorrhoids were more frequent in the PD, esophagitis and hiatal hernia were more frequent in the HD.

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Section: Discussionmentioning

confidence: 99%

Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities

Karahan

Şahi̇n

2022

BMC Nephrol

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“…Patients with ESKD have lower gastric pH and higher gastrin levels than people without kidney failure in some but not all studies. 20 - 22 Hypergastrinemia has been associated with an inability to wean PPIs in the general population. 2 …”

Section: Discussionmentioning

confidence: 99%

“…Patients with ESKD have lower gastric pH and higher gastrin levels than people without kidney failure in some but not all studies. [20][21][22] Hypergastrinemia has been associated with an inability to wean PPIs in the general population. 2 Although much has been written about the potential harms of PPIs, little has been written about the potential harms associated with discontinuing this class of medications.…”

Section: Discussionmentioning

confidence: 99%

De-Prescribing Proton Pump Inhibitors in Patients With End Stage Kidney Disease: A Quality Improvement Project

Czikk

Parpia

Roberts

et al. 2022

Can J Kidney Health Dis

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Background: Proton pump inhibitors (PPIs) are widely prescribed and may be associated with harm; hypomagnesemia and reduced effectiveness of calcium carbonate phosphate binders may be important in end-stage kidney disease (ESKD). Objectives: Our objectives included (1) discontinuing PPIs and H2 blockers and (2) assessing the impact on serum magnesium and markers of mineral metabolism. Design: Prospective cohort. Setting: Satellite hemodialysis unit of a tertiary care hospital. Patients: Incident and prevalent patients with ESKD treated with hemodialysis. Measurements: We assessed the impact of stopping PPI/H2 blockers in patients who did not have an absolute indication as per guidelines in the general population; serum magnesium, calcium, and phosphate were measured before and approximately 8 weeks later. Analysis of variance (ANOVA) test and Kruskal-Wallis was used to describe the population. Wilcoxon signed rank test for the paired change scores (from pre to post) Methods: The electronic medical record (EMR) was extensively searched for absolute indications for a PPI. Results were reviewed with the primary nephrology team before approaching patients about stopping the PPI. Basic demographic information and select medications were also collected. Results: Electronic medical records were reviewed for 179 patients, 74 had a PPI or H2 antagonist or both on their medication list (43%); 23 (31%) were assessed as appropriate. After primary team and patient review, 29 patients agreed to a trial of PPI withdrawal. Fourteen patients restarted their PPI, most for gastroesophageal reflux disease. Three patients had a GI bleed, 1 fatally. Serum calcium ( P = .17) and the dose of phosphate binders ( P = .075) did not change but serum phosphate increased (1.55 [0.29] to 1.85 [0.34] mmol/L; P = .0005). Serum magnesium also increased (1.01 [0.16] to 1.06 [0.14] mmol/L; P = .01). Limitations: Small patient numbers and observational nature of the study does not establish causation in this population at high risk to experience a gastrointestinal bleed. Conclusions: Our results suggest that PPI deprescribing as recommended in the general population may be associated with harm in patients with ESKD and requires further study. Trial Registration: Not registered.

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“…Nevertheless, the available literature data on the HP presence in hemodialysis patients are quite unequal with a wide range of variation (20-80%) (14,15). There are also different opinions on the frequency of gastroduodenal lesions in hemodialysis CKD patients compared to non-CKD subjects (16). Some authors reported that hemodialysis patients suffered more often from gastroduodenal disorders while the others not found the differences between hemodialysis and the general population (13,17,18).…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Helicobacter Pylori Infection in Patients with Chronic Kidney Disease Undergoing Hemodialysis

Babovic

Djuranović

Mihaljevic

et al. 2022

Serbian Journal of Experimental and Clinical Research

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The aim of this study was to analyze the prevalence of Helicobacter pylori infection and gastroduodenal lesions in Montenegrin patients with chronic kidney disease on hemodialysis. The study included 55 hemodialysis patients with dyspeptic symptoms and 50 control subjects with normal kidney function who had also dyspepsia. After dyspepsia assessment by an interview, all subjects underwent gastroduodenoscopy and histopathological analysis of biopsy specimens, taken from the corpus and antrum of the stomach. Helicobacter pylori was confirmed in 50.9% of corpus mucosa i.e. 60.6% of antrum mucosa of maintenance hemodialysis patients. There were no significantly differences in endoscopic findings of the stomach and bacterial presence between the two study groups of participants (p = 0.451), while duodenal lesions were prevalent in control subjects (p < 0.001). The atrophy of corpus mucosa was more common in hemodialysis patients (p = 0.007), especially in those who have been on hemodialysis for a longer time (p < 0.001) and had lower pH (p = 0.011). The prevalence of Helicobacter pylori infection shown an inverse relationship with dialysis duration. Contrary, a positive relationship between Helicobacter pylori and the concentration of bicarbonate was demonstrated (p = 0.031). The prevalence of Helicobacter pylori and atrophic mucosal changes in Montenegrin hemodialysis patients depends on dialysis duration and acid-base balance.

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Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: a review of literature

Cited by 13 publications

References 56 publications

Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities

Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities

De-Prescribing Proton Pump Inhibitors in Patients With End Stage Kidney Disease: A Quality Improvement Project

The Prevalence of Helicobacter Pylori Infection in Patients with Chronic Kidney Disease Undergoing Hemodialysis

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