Gastrointestinal Evaluation in Chronic Kidney Diseases

Abstract

Background: Upper gastrointestinal (GI) symptoms are common in patients with severe chronic renal failure. The aim of this prospective study is to determine the prevalence of GI abnormalities and Helicobacter pylori (H. pylori) infection and assess the importance of GI evaluation among in pretransplantation with CKD patients

Prevalance, Endoscopic and Histopathological Features of Helicobacter Pylori (H.PYLORI) Infection in Chronic Kidney Disease (Ckd) / End Stage Renal Disease (Esrd) Versus Normal Population at a Tertiary Care Center in North India: A Case Control Hospital Based Study.

“…Inclusion criteria:- All diagnosed cases of CKD/ESRD with upper gastrointestinal tract symptoms like GERD, dyspepsia, belching and APD. Discussion:-Endoscopic findings were abnormal in 63 (90%)of Cases (CKD/ESRD) with antral gastritis in 29 (42%), duodenits in 17 (24%), duodenal ulcer in 10 (14%)and antral erythema in 7 (10%) while as EGD findings were abnormal in 39 (78%) of controls (Normal kidney functions) with Antral gastritis in 16 (32%),duodenits in 10 (20%),duodenal ulcer 8 (16%) and antral erythema 5 (10%).Although EGD findings are more common in cases than controls ,but statistically there was no significant difference with (p-value >0.05) which is in agreement with published data (22,24,26). Detection of H.Pylori by RUT and HPE.Our study demonstrated that among cases Rapid urease test (RUT) was positive in 57 (81.4%), Negative in 10 (14.3%) and inconclusive in 3 (4.3%) while as among controls RUT was positive in 42 (84%), Negative in 8 (16%) with ( p-value=0.329).Histopathological examination (HPE) among cases H.Pylori was positive in 52 (74.3%),Negative in 15 (21.4%) an inconclusive in 3 (4.3%) while as among controls H.Pylori was positive in 40(80%),Negative in 9(18%) and inconclusive in 1(2%) with (p-value=0.686).From these results we observe that there is no significant difference in prevalence of H.Pylori between cases and controls with (p-value >0.05) which is consistent with published data (16,21,22,25,26,27).Chronic active gastritis was seen in 51(72.9%),Chronic Inactive Gastrits14(20%),Acute Gastritis in 3(4.3%) and normal findings in 2(2.9%).while among Controls Chronic active gastritis was present in 34(68%),Chronic Inactive Gastritis in 6(12%),Acute gastritis in 5(10%) and Normal in 5(10%).From these observations we found that there is no statistically significant differences in HPE findings between cases and controls with (p-value=0.08) which goes in agreement with published data (16 ).…”

Upper gastrointestinal alterations in kidney transplant candidates

“…Patients on dialysis are often affected by UGI tract diseases 12 , 5 Given the lack of studies on this topic in Brazil, this study aimed to look into these conditions and verify the validity of routinely carrying out upper endoscopies in kidney transplant candidates at the HEL Transplant Service.…”

“…Managing patients with chronic kidney disease (CKD) can be challenging on account of the significant number of comorbidities they present, which include diseases of the upper gastrointestinal (UGI) tract often undetected due to the poor correlation between clinical findings and diagnostic tests 1. Therefore, screening endoscopic examination is needed to catch UGI diseases in patients with CKD.…”

“…The pathophysiology of UGI injuries is complex and stems, among other things, from the use of medication to deal with the comorbidities and metabolic alterations arising from CKD; increased gastrin and ammonia serum levels; gastroesophageal reflux disease; and infection by H. pylori. 1 , 2…”

“…The high incidence of GI disorders in kidney transplant candidates is well documented in the literature 12 , 5 However, there is an absolute lack of Brazilian data on the matter.…”