Department of Nephrology, Clinical Center of Montenegro, Podgorica, Montenegro.
Clinic for Gastroenterohepatology, University Clinical Center of Serbia, Belgrade, Serbia.
Int Urol Nephrol. 2022 Aug;54(8):1891-1897. doi: 10.1007/s11255-021-03075-3. Epub 2021 Nov 27.
The main purpose of this study was to analyze the characteristics of dyspepsia and contributing factors in Montenegrin maintenance hemodialysis patients.
The study included 43 patients undergoing hemodialysis with symptoms of dyspepsia and 40 control dyspeptic subjects with preserved kidney function. All subjects underwent an interview about dyspeptic symptoms, physical and biochemical examination, and upper gastrointestinal endoscopy with pathohistological analysis of biopsy specimens.
Early satiety, bloating and heartburn were the most common symptoms in hemodialysis patients but without significant difference in frequency in relation to controls. Chronic kidney disease patients had statistically lower concentration of total proteins and albumin (p < 0.001), as well lower BMI values (p = 0.002). Despite this, no significant correlation of laboratory parameters with dyspeptic symptoms was found. Pathohistological examination indicated that the most common finding in hemodialysis patients was chronic active gastritis (58%), while chronic atrophic gastritis was significantly more common in dialytic patients (p = 0.032). Patients on hemodialysis had more frequently atrophy of corpus mucosa, which was positively related to dialysis duration (p = 0.001) and negatively related to pH values (p = 0.004) and bicarbonate concentration (p = 0.049). Helicobacter pylori was considerably more common in patients who underwent shorter time on hemodialysis (p < 0.001) and had higher values of bicarbonate (p = 0.037).
Maintenance hemodialysis patients are at risk for chronic gastric diseases that correlated with both dialysis vintage and duration.
本研究的主要目的是分析黑山维持性血液透析患者消化不良的特征和相关因素。
本研究纳入了 43 例有消化不良症状且正在接受血液透析的患者和 40 例肾功能正常的对照患者。所有患者均接受了关于消化不良症状的访谈、体格检查和生化检查，以及上消化道内窥镜检查和活检组织的病理分析。
早饱、腹胀和烧心是血液透析患者最常见的症状，但与对照组相比，其频率无显著差异。慢性肾脏病患者的总蛋白和白蛋白浓度显著降低（p<0.001），BMI 值也显著降低（p=0.002）。尽管如此，并未发现实验室参数与消化不良症状之间存在显著相关性。病理检查结果表明，血液透析患者最常见的发现是慢性活动性胃炎（58%），而慢性萎缩性胃炎在透析患者中更为常见（p=0.032）。血液透析患者的胃体黏膜萎缩更为常见，且与透析时间呈正相关（p=0.001），与 pH 值呈负相关（p=0.004），与碳酸氢盐浓度呈负相关（p=0.049）。在透析时间较短和碳酸氢盐水平较高的患者中，幽门螺杆菌更为常见（p<0.001）。
维持性血液透析患者易患与透析时间和时长相关的慢性胃部疾病。
