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不同肾脏替代治疗方式的胃肠道症状和发现比较。

Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities.

机构信息

Departmant of Internal Medicine, Malatya Turgut Özal University School of Medicine, Malatya Training and Research Hospital, Özalper. Turgut Özal Ave. No:4, 44330, Malatya, Turkey.

Departmant of Nephrology, İnonu University School of Medicine, Malatya, Turkey.

出版信息

BMC Nephrol. 2022 Jul 23;23(1):261. doi: 10.1186/s12882-022-02893-6.

Abstract

OBJECTIVE

Chronic kidney disease (CKD) affects gastrointestinal system (GIS) and causes histological, functional and mucosal changes. There are scarce data investigating GIS symptoms and findings in patients with CKD stage III-V, receiving hemodialysis (HD) and peritoneal dialysis (PD). In this study, we aimed to evaluate the frequency of gastrointestinal symptoms and findings and compare between renal replacement therapies.

METHOD

A total of 290 patients (97 in CKD stage III-V, 92 PD, 101 HD) were included in this study. Gastrointestinal complaints, diseases, background characteristics of patients and drugs they used were questioned by interviews, forms were filled and examinations of patients were performed. Results of upper GIS endoscopy, colonoscopy, abdominal ultrasonography and tomography of patients were evaluated.

RESULTS

The most common signs were dyspepsia (50%), nausea (45%) and epigastric pain (44%) among all patients, generally. Gastrointestinal disorders like gastritis (62%) and gastroesophageal reflux (39%) were frequent in patients. Prevalence of patients with weight loss was 20% in predialysis and 8% in PD and the ratio was higher in predialysis group statistically significantly (p = 0,016). The prevalence of gastritis was 70% in PD, 55% in HD and the prevalence of hemorrhoids was 24% in PD and 12% in HD. The prevalence of gastritis and hemorrhoids was higher in the PD group than in the HD group statistically significantly (p = 0.043, p = 0.028), otherwise, there wasn't a difference between the PD and predialysis groups, statistically significantly.

CONCLUSION

This study showed that; gastrointestinal symptoms and disorders were very common in CKD, besides this; while gastritis and hemorrhoids were more frequent in the PD, esophagitis and hiatal hernia were more frequent in the HD.

摘要

目的

慢性肾脏病(CKD)会影响胃肠道系统(GIS),并导致组织学、功能和黏膜变化。关于接受血液透析(HD)和腹膜透析(PD)的 CKD Ⅲ-Ⅴ期患者的 GIS 症状和发现,相关数据十分有限。本研究旨在评估胃肠道症状和发现的频率,并比较两种肾脏替代疗法。

方法

共纳入 290 例患者(CKD Ⅲ-Ⅴ期 97 例,PD 92 例,HD 101 例)。通过访谈、填写表格和对患者进行检查,询问胃肠道主诉、疾病、患者的背景特征和所用药物。评估患者上胃肠道内镜、结肠镜、腹部超声和 CT 结果。

结果

所有患者中最常见的症状是消化不良(50%)、恶心(45%)和上腹痛(44%)。胃炎(62%)和胃食管反流(39%)等胃肠道疾病较为常见。在透析前患者中,体重减轻的发生率为 20%,PD 患者中为 8%,透析前组的发生率明显更高(p=0.016)。PD 患者中胃炎的发生率为 70%,HD 患者中为 55%,PD 患者中痔疮的发生率为 24%,HD 患者中为 12%。PD 组中胃炎和痔疮的发生率明显高于 HD 组(p=0.043,p=0.028),而 PD 组与透析前组之间无统计学差异。

结论

本研究表明,除 CKD 外,胃肠道症状和疾病也很常见;此外,PD 中更常见胃炎和痔疮,HD 中更常见食管炎和食管裂孔疝。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f3/9308180/5fd6811cd776/12882_2022_2893_Fig1_HTML.jpg

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