Anderson J E, Yim K B, Crowell M D
Division of Renal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
Adv Perit Dial. 1999;15:75-8.
The prevalence of gastrointestinal reflux disease (GERD) in hemodialysis (HD) and peritoneal dialysis (PD) patients was assessed at a single center with a self-administered questionnaire previously used in a general population. It defines (GERD as the presence of heartburn or acid regurgitation, or both. Risk factors for GERD and GERD-associated symptoms were also evaluated. In the studied population, 29.7% of patients had frequent GERD (heartburn, acid regurgitation, or both symptoms weekly). Frequent GERD was reported by 44.7% of PD patients versus the 18.9% reported by HD patients and the 19.8% reported by the general population. PD and HD patients had similar GERD severity scores [2.3 +/- 0.7 vs 1.9 +/- 0.8, mean +/- standard deviation (SD)]. PD and HD patients reported atypical GERD symptoms at rates similar to those reported by the general population, but having GERD made some atypical GERD symptoms more likely (p < 0.05, Fisher's exact test). In a logistic model, age < 60 [odds ratio (OR) 5.6, confidence interval (CI) 1.5-21.3], smoking (OR 4.7, CI 1.3-16.9), and body mass index > or = 27 (OR 3.9, CI 1.2-13.0) predicted GERD. Sex, race, diabetes, PD, non steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers, and coffee and alcohol use did not. GERD is more common in PD patients than in HD patients or in the general population. It is not clear whether PD per se is a risk factor for GERD.
在一个单中心,采用先前用于普通人群的自填式问卷,评估了血液透析(HD)和腹膜透析(PD)患者的胃食管反流病(GERD)患病率。该问卷将GERD定义为烧心或反酸,或两者皆有。还评估了GERD的危险因素及与GERD相关的症状。在研究人群中,29.7%的患者有频繁GERD(烧心、反酸或两种症状每周均出现)。44.7%的PD患者报告有频繁GERD,而HD患者报告的比例为18.9%,普通人群报告的比例为19.8%。PD和HD患者的GERD严重程度评分相似[2.3±0.7对1.9±0.8,均值±标准差(SD)]。PD和HD患者报告的非典型GERD症状发生率与普通人群相似,但患有GERD会使一些非典型GERD症状更易出现(p<0.05,Fisher精确检验)。在逻辑模型中,年龄<60岁[比值比(OR)5.6,置信区间(CI)1.5 - 21.3]、吸烟(OR 4.7,CI 1.3 - 16.9)和体重指数≥27(OR 3.9,CI 1.2 - 13.0)可预测GERD。性别、种族、糖尿病、PD、非甾体抗炎药(NSAIDs)、钙通道阻滞剂以及咖啡和酒精的使用则不能预测。GERD在PD患者中比在HD患者或普通人群中更常见。目前尚不清楚PD本身是否为GERD的危险因素。