Relationship between Nutritional Status and Gastrointestinal Symptoms in Geriatric Patients with End-Stage Renal Disease on Dialysis

Abstract

Gastrointestinal symptoms (GIS) are common in patients with end-stage renal disease (ESRD) and are associated with nutritional risks resulting from low food intake. Little is known about the relationship between GIS and malnutrition in geriatric patients with ESRD. The main objective of this study was to determine the relationship between nutritional status and severity of GIS in geriatric patients on dialysis therapy. Clinically-stable geriatric patients (older than 60 years old) who were dialysis outpatients were included in this cross-sectional study. The severity of GIS was assessed using the Gastrointestinal Symptoms Questionnaire (GSQ, short version), with patients classified into three groups: mild, moderate, and severe. Nutritional status was evaluated with the Malnutrition Inflammation Score (MIS), anthropometric assessment, biochemical parameters, and bioelectrical impedance. Descriptive statistics were used and differences between groups were analyzed with ANOVA and Kruskal Wallis, with a p < 0.05 considered to indicate significance. Fifty patients completed the study; the median age was 67 years old. Twenty-three patients were on hemodialysis (HD) and 27 were on peritoneal dialysis (PD). No significant differences were found according to dialysis modality, presence of diabetes, or gender. Ninety percent of patients had at least one GIS. Poorer nutritional status (evaluated by MIS) was related to a higher severity of GIS. There were no significant differences with other nutritional parameters. Our study showed a high prevalence of GIS in geriatric patients. There were no differences in observed GIS values that were attributed to dialysis modality, gender, or presence of type 2 diabetes mellitus (DM2). Severe GIS values were associated with poorer nutritional status determined by MIS, however, there was no association with anthropometry, biochemical values, or bioimpedance vector analysis.

Prevalence and Determinants of Gastrointestinal Symptoms in Adults on Maintenance Hemodialysis in Cameroon

“…We observed a high prevalence of GIS occurring in 87.9% similar to the prevalence in geriatric population [21]. This prevalence was very high compare to frequencies reported in the literature [1]- [7].…”

“…As reported in Asian patients, we did not found an association between the presence of GIS and diabetes mellitus [7]. Our study did not report any association between age as well gender and the presence of GIS as observed in such patients elsewhere [13] [14] [21]. We did not observe any association between the presence of GIS and longer duration in dialysis as reported by the literature [2] [13].…”

Nutritional Risk Screening Tools for Elderly Patients with COVID-19: A Systematic Review

“…Furthermore, gastrointestinal symptoms such as vomiting and diarrhea [85,86] and loss of taste (ageusia) and smell (anosmia) have been reported in patients with COVID-19 [87][88][89]. Gastrointestinal symptoms generally result in deterioration of intestinal permeability, harmful changes in intestinal microbiota, and low food consumption [90,91]. This may also favor identification of nutritional risk in elderly patients with COVID-19, as most nutritional screening instruments establish reduced food consumption as an evaluation criterion.…”

The Effect of Baru (Dypterix alata Vog.) Almond Oil on Markers of Bowel Habits in Hemodialysis Patients

“…Gastrointestinal symptoms are common in patients with chronic kidney disease (CKD) [ 1 ]. According to Carrera-Jiménez et al [ 2 ], 90% of dialysis patients reported, at least, one gastrointestinal symptom. Bowel habit alterations are generally associated with a low intake of dietary fibers and liquids, oral iron supplementation, phosphate binders, and low a level of physical activity; however, such conduct and behaviors are frequently part of hemodialysis (HD) patients' treatment [ 3 ].…”