Zuvela Jordan, Trimingham Claire, Le Leu Richard, Faull Randall, Clayton Philip, Jesudason Shilpa, Meade Anthony
Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Flinders University, Adelaide, South Australia, Australia.
Nephrology (Carlton). 2018 Aug;23(8):718-727. doi: 10.1111/nep.13243.
The aim of the present study was to describe the prevalence of all gastrointestinal (GI) symptoms reported by dialysis patients, as well as the tools being used for diagnosis. GI symptoms are commonly reported in patients having haemodialysis (HD) and peritoneal dialysis (PD), but there are multiple definitions and assessment tools reported in the literature.
A comprehensive systematic review was undertaken using five databases (Embase, Medline, CINAHL, Psycinfo and Web of Science) between 1996 and 2017. Articles were critically appraised using the Newcastle Ottawa Scale (NOS). Data collected were analyzed in a Microsoft Excel spreadsheet.
Thirty studies (24 cross-sectional, six cohort) met the inclusion criteria. In total 5161 patients were studied (3804 HD and 1507 PD). Fifteen studies included HD, five included PD and 10 included both dialysis modalities. GI symptoms were heterogeneous, with the reported prevalence highly dependent on the definitions used, inclusion/exclusion criteria, assessment tools and methods used. The most prevalent symptoms were constipation, indigestion, abdominal pain and reflux. Medication use and dietary data were poorly reported. The most common tools used were Gastrointestinal Symptom Rating Scale (GSRS), Rome II and Rome III. Constipation was more common in HD patients than PD patients. Indigestion, abdominal pain and reflux were commonly reported in both dialysis modalities.
Gastrointestinal symptoms are highly prevalent in people on dialysis; however, the evidence base is limited and further investigation of preventable causes and potential interventions such as medications and diet are required in future research.
本研究旨在描述透析患者报告的所有胃肠道（GI）症状的患病率，以及用于诊断的工具。血液透析（HD）和腹膜透析（PD）患者中普遍报告有GI症状，但文献中报道了多种定义和评估工具。
在1996年至2017年期间，使用五个数据库（Embase、Medline、CINAHL、Psycinfo和Web of Science）进行了全面的系统评价。使用纽卡斯尔渥太华量表（NOS）对文章进行严格评估。收集的数据在Microsoft Excel电子表格中进行分析。
30项研究（24项横断面研究，6项队列研究）符合纳入标准。总共对5161例患者进行了研究（3804例HD患者和1507例PD患者）。15项研究纳入了HD患者，5项纳入了PD患者，10项纳入了两种透析方式的患者。GI症状具有异质性，报告的患病率高度依赖于所使用的定义、纳入/排除标准、评估工具和方法。最常见的症状是便秘、消化不良、腹痛和反流。药物使用和饮食数据报告不佳。最常用的工具是胃肠道症状评定量表（GSRS）、罗马II和罗马III。便秘在HD患者中比PD患者更常见。消化不良、腹痛和反流在两种透析方式中都普遍存在。
透析患者中胃肠道症状非常普遍；然而，证据基础有限，未来研究需要进一步调查可预防的原因以及药物和饮食等潜在干预措施。
