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与血液透析患者肠易激综合征症状相关的因素。

Factors associated with irritable bowel syndrome symptoms in hemodialysis patients.

机构信息

Department of Internal Medicine, Nephrology and Transplantation Medicine, Central Clinical Hospital of Ministry of Home Affairs, 02-507 Warsaw, Poland.

出版信息

World J Gastroenterol. 2011 Apr 21;17(15):1976-81. doi: 10.3748/wjg.v17.i15.1976.

Abstract

AIM

To investigate clinical characteristics associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients.

METHODS

This was a cross-sectional study. A questionnaire based on the Bowel Disease Questionnaire that records gastrointestinal symptoms was given to 294 patients in 4 dialysis centers. A total of 196 (67%) subjects returned the survey. A multivariable logistic regression model was used to identify factors significantly associated with IBS symptoms.

RESULTS

Symptoms compatible with IBS were present in 27 (13.8%) subjects and independently associated with low post-dialysis serum potassium [OR = 0.258, 95% CI (0.075-0.891), P = 0.032], paracetamol use [OR = 3.159, 95% CI (1.214-8.220), P = 0.018], and Kidney Disease Quality of Life (KDQOL) cognitive function score [OR = 0.977, 95% CI (0.956-0.999), P = 0.042]. Univariate regressions were also performed and the reported significance is for multivariate analysis. No association was detected for age, gender, depressed mood, smoking (present or past), body mass index, albumin level, Kt/V, sodium pre- or post-dialysis level, change in potassium level during HD, proton pump inhibitor or H2 blocker use, aspirin use, residual diuresis, hepatitis B or C infection, diabetes mellitus, marital status and education level.

CONCLUSION

This study examined potential risk factors for symptoms compatible with IBS in HD patients and identified an association with paracetamol use, post-dialysis potassium level and KDQOL-cognitive function score.

摘要

目的

探讨与血液透析(HD)患者存在肠易激综合征(IBS)症状相关的临床特征。

方法

这是一项横断面研究。在 4 家透析中心,向 294 名患者发放了基于记录胃肠道症状的肠病问卷的问卷。共有 196 名(67%)受试者返回了调查。使用多变量逻辑回归模型来确定与 IBS 症状显著相关的因素。

结果

27 名(13.8%)受试者存在符合 IBS 的症状,且与低透析后血清钾[比值比(OR)=0.258,95%置信区间(CI)(0.075-0.891),P=0.032]、使用对乙酰氨基酚[OR=3.159,95%CI(1.214-8.220),P=0.018]和肾脏病生活质量(KDQOL)认知功能评分[OR=0.977,95%CI(0.956-0.999),P=0.042]独立相关。还进行了单变量回归,报告的显著性为多变量分析。年龄、性别、抑郁情绪、吸烟(现在或过去)、体重指数、白蛋白水平、Kt/V、透析前或透析后钠水平、HD 期间钾水平变化、质子泵抑制剂或 H2 阻滞剂使用、使用阿司匹林、残余尿量、乙型肝炎或丙型肝炎感染、糖尿病、婚姻状况和教育水平与症状均无关联。

结论

本研究检查了 HD 患者与 IBS 症状相关的潜在危险因素,并确定了与对乙酰氨基酚使用、透析后钾水平和 KDQOL 认知功能评分的关联。

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