Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemodialysis or Peritoneal Dialysis or With Non-End Stage Renal Disease

Lee, Yi Che; Hung, Shih Yuan; Wang, Hsi Hao; Wang, Hao‐Kuang; Lin, Chi Wei; Chang, Min-Yu; Ho, Li-Chun; Chen, Yi Ting; Wu, Ching-Feng; Chen, Ho Ching; Wang, Wei Ming; Sung, Junne Ming; Chiou, Yuan Yow; Lin, Sheng Hsiang

doi:10.1097/md.0000000000001482

Cited by 51 publications

(39 citation statements)

References 30 publications

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“…In contrast to the sofosbuvir-based treatment regimens [27], in PrOD regimen, patients may continue omeprazole administration without treatment efficacy alterations. This is important especially in haemodialysed patients, who have a higher risk of gastrointestinal bleeding in comparison with general population [28, 29]. They often use low-dose aspirin or other anti-platelet agents to prevent the arteriovenous fistula occlusion, and they are regularly given anticoagulants during haemodialysis sessions.…”

Section: Discussionmentioning

confidence: 99%

Paritaprevir/Ritonavir/Ombitasvir Plus Dasabuvir Regimen in the Treatment of Genotype 1 Chronic Hepatitis C Infection in Patients with Severe Renal Impairment and End-Stage Renal Disease: a Real-Life Cohort

Šperl

Kreidlová

Merta

et al. 2018

Kidney Blood Press Res

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Background/Aims: Chronic hepatitis C (HCV) virus infection reactivates under immunosuppressive drugs and therefore has a negative impact on long-term survival of kidney transplant recipients. Treatment-induced clearance of hepatitis C virus (HCV) in kidney transplant candidates prevents virus reactivation after transplantation. Paritaprevir/Ritonavir/Ombitasvir with Dasabuvir (PrOD) represents a highly effective treatment regimen for HCV genotype 1 (GT1), also suitable for patients with end-stage renal disease (ESRD). Serious drug-drug interactions may represent a limiting factor of this regimen. The aim of this retrospective study was to evaluate safety, efficacy and drug-drug interactions management associated with PrOD treatment in the Czech real-world cohort. Methods: Emphasizing concomitant medication adjustment, we described the treatment course with PrOD regimen in 23 patients (4 with CKD4 and 19 on maintenance haemodialysis) infected with HCV GT1 (21 GT1b, 2 GT1a), 18 males and 5 females with an average age of 53.7 years. Six patients had compensated liver cirrhosis and 3 of them were liver transplant recipients. Results: All 23 patients completed the 12-week treatment and achieved sustained virological response 12 weeks after the treatment (SVR12 rate 100%). None of the patients presented with a significant decrease in haemoglobin level, white blood cell and platelet count during the treatment period. The most frequent adverse events were nausea, hypotension, diarrhoea, and hyperkalemia. Four patients presented with a serious adverse event unrelated to the antiviral drugs (salmonellosis, non-functional kidney graft rejection, early gastric cancer, renal cyst infection, initiation of haemodialysis). Concomitant medication had to be modified with the treatment initiation in 10 out of 23 (43.5%) patients (calcium channel blockers, ACE inhibitors, statins, diuretics, tacrolimus); four patients required further adjustment of antihypertensive drugs or tacrolimus dosage on-treatment. Conclusion: PrOD regimen demonstrated an excellent efficacy and good tolerability. Both prospective adjustment of concomitant medication and further on-treatment adjustment allowed for a safe treatment course.

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Section: Discussionmentioning

confidence: 99%

Paritaprevir/Ritonavir/Ombitasvir Plus Dasabuvir Regimen in the Treatment of Genotype 1 Chronic Hepatitis C Infection in Patients with Severe Renal Impairment and End-Stage Renal Disease: a Real-Life Cohort

Šperl

Kreidlová

Merta

et al. 2018

Kidney Blood Press Res

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“…The risk of peptic ulcer disease, lower GI diverticula and bleeding is significantly higher in the HD group implying the effects of intradialytic ischemia and dialysis anticoagulation. Meanwhile, the risk of mesenteric ischemia, liver cirrhosis, and acute pancreatitis does not differ between the PD and HD groups; moreover, the risk of appendicitis in the PD group might be lower than that in the HD group [10].…”

Section: Prevalencementioning

confidence: 99%

Gastrointestinal Disorders in Peritoneal Dialysis Patients

et al. 2018

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Background: Gastrointestinal (GI) disorders in peritoneal dialysis (PD) patients are relatively understudied in the literature, even though they have a serious impact in the morbidity parameters and the quality of life for this group of patients. Various diagnostic tools have been used, including instrumental methods and questionnaires, invariably validated in comparative studies. Summary: The prevalence of GI disorders is very high in PD patients. Compared to the haemodialysis patients they present a higher prevalence of reflux, eating dysfunction, gastroesophageal reflux, intestinal obstruction or adhesions and abdominal hernia. They may be divided into Gastric disorders (Gastroesophageal reflux disease, pathological Gastric emptying, Dyspepsia, Helicobacter pylori infection, peptic ulcers) and Intestinal disorders (Peritonitis, Diverticulosis, Constipation). Key Messages: The current paper is a review of the literature involving GI disorders in PD patients. This special group of patients with a special role of the peritoneal cavity and the GI motility in the physiology of their dialysis merit a larger number of studies dealing with the interrelation of the GI tract and the PD physiological, functional and pathophysiological parameters.

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“…By contrast, HD patients have higher hepatitis B and C infection risks, and chronic hepatitis B and C are risk factors for hepatocellular carcinoma . A previous study also found that HD patients had a higher risk of peptic ulcer disease (PUD) than PD patients, and PUD has been proven to have a high correlation with Helicobacter pylori infection . Helicobacter pylori is definitely carcinogenic in the case of gastric cancer .…”

Section: Introductionmentioning

confidence: 98%

Is there different risk of cancer among end‐stage renal disease patients undergoing hemodialysis and peritoneal dialysis?

et al. 2018

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Cancer is a global issue in recent decade. Despite this alarming increase in the incidence of cancer, to date, whether the risk of developing cancer differs among peritoneal dialysis (PD) and hemodialysis (HD) patients is still uncertain. In this retrospective cohort study, data were obtained from the National Health Insurance Research Database of Taiwan, which provides coverage to almost 99% of the nation's population. After matching, a total of 4491 (or 3369) incident PD patients and 8982 (or 6738) incident HD patients between 2000 and 2009 were enrolled from the database. In addition, 22,455 (or 16,845) nondialysis patients were selected as a control group. The patients were monitored for the occurrence of cancer until 2010, and their data were analyzed using several different models. In general, the results showed that the risks of hepatocellular, kidney, bladder, extra kidney/bladder urinary tract, and thyroid cancers were higher in dialysis patients. We also compared the risk of cancer between two dialysis groups by using the HD patients as the reference group. The result showed that there is no significant different for each cancer risk between two dialysis groups. In conclusion, dialysis patients had a higher risk of certain types of cancer than those in the nonuremia group. However, there was no significant difference in the cancer risk between the two dialysis groups when compared directly.

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Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemodialysis or Peritoneal Dialysis or With Non-End Stage Renal Disease

Abstract: Supplemental Digital Content is available in the text

Cited by 51 publications

References 30 publications

Paritaprevir/Ritonavir/Ombitasvir Plus Dasabuvir Regimen in the Treatment of Genotype 1 Chronic Hepatitis C Infection in Patients with Severe Renal Impairment and End-Stage Renal Disease: a Real-Life Cohort

Paritaprevir/Ritonavir/Ombitasvir Plus Dasabuvir Regimen in the Treatment of Genotype 1 Chronic Hepatitis C Infection in Patients with Severe Renal Impairment and End-Stage Renal Disease: a Real-Life Cohort

Gastrointestinal Disorders in Peritoneal Dialysis Patients

Is there different risk of cancer among end‐stage renal disease patients undergoing hemodialysis and peritoneal dialysis?

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