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接受透析的终末期肾病患者消化性溃疡疾病的危险因素。

Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

作者信息

Kim Minah, Kim Chang Seong, Bae Eun Hui, Ma Seong Kwon, Kim Soo Wan

机构信息

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

出版信息

Kidney Res Clin Pract. 2019 Mar 31;38(1):81-89. doi: 10.23876/j.krcp.18.0060.

Abstract

BACKGROUND

Compared to the general population, patients with end-stage renal disease have more gastrointestinal symptoms and a higher prevalence of peptic ulcer. Risk factors for peptic ulcer disease in patients with end-stage renal disease, however, remain poorly defined. This study aims to better identify those risk factors.

METHODS

We analyzed 577 patients with end-stage renal disease from 2004 to 2016. We excluded patients with life-threatening conditions. All patients underwent upper endoscopy. We analyzed patient medical records, medication history, and endoscopic findings. Independent sample test, chi-square test, Fisher's exact test, and multiple logistic regression analysis were used in statistical analyses.

RESULTS

Of the 577 patients with end-stage renal disease, 174 had peptic ulcer disease (gastric or duodenal ulcer). Patients on hemodialysis had a higher prevalence of peptic ulcer disease than those on peritoneal dialysis. Patients with peptic ulcer disease had lower serum albumin level and higher blood urea nitrogen level than those without peptic ulcer disease. Positive scores on two or more nutritional indices (albumin, serum cholesterol, uric acid, and creatinine levels) were associated with peptic ulcer disease in end-stage renal disease.

CONCLUSION

Hemodialysis, hypoalbuminemia, and multiple malnutrition indices were associated with the prevalence of peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

摘要

背景

与普通人群相比,终末期肾病患者有更多的胃肠道症状,消化性溃疡的患病率更高。然而,终末期肾病患者消化性溃疡疾病的危险因素仍未明确界定。本研究旨在更好地识别这些危险因素。

方法

我们分析了2004年至2016年期间的577例终末期肾病患者。我们排除了患有危及生命疾病的患者。所有患者均接受了上消化道内镜检查。我们分析了患者的病历、用药史和内镜检查结果。统计分析采用独立样本检验、卡方检验、Fisher精确检验和多元逻辑回归分析。

结果

在577例终末期肾病患者中,174例患有消化性溃疡疾病(胃溃疡或十二指肠溃疡)。接受血液透析的患者消化性溃疡疾病的患病率高于接受腹膜透析的患者。与没有消化性溃疡疾病的患者相比,患有消化性溃疡疾病的患者血清白蛋白水平较低,血尿素氮水平较高。在两个或更多营养指标(白蛋白、血清胆固醇、尿酸和肌酐水平)上得分为阳性与终末期肾病患者的消化性溃疡疾病相关。

结论

血液透析、低白蛋白血症和多种营养不良指标与接受透析的终末期肾病患者消化性溃疡疾病的患病率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d92c/6481975/bd7a9b9329d2/krcp-38-081f1.jpg

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