Department of Internal Medicine, Erciyes Medical Faculty, Kayseri, Turkey.
Department of Nephrology, Kayseri Education And Research Hospital, Kayseri, Turkey.
Int Urol Nephrol. 2024 Oct;56(10):3343-3350. doi: 10.1007/s11255-024-04044-2. Epub 2024 May 23.
The aim of this study is to determine whether there is a relationship between peritoneal membrane permeability and dyspepsia in peritoneal dialysis patients.
This study included 95 peritoneal dialysis patients aged 18 and older. The presence of dyspepsia in patients was recorded according to the 2016 ROME-IV Functional Dyspepsia Diagnostic Criteria. Subsequently, the Glasgow Dyspepsia Severity Score questionnaire was administered to assess the severity of dyspepsia. Endoscopy was performed for those who agreed to exclude organic pathology, or the results of endoscopy conducted within the last 2 years were recorded. Furthermore, stool samples were examined for H. pylori to exclude organic causes of dyspepsia. PET (peritoneal equilibration test) and Kt/V values of patients were calculated using the "PD Adequest" computer software. PET values were categorized as low and low-normal for low permeability and high and high-normal for high permeability.
Dyspepsia was detected in 51.6% of all peritoneal dialysis patients. H. pylori was found positive in 11.6% of all patients and 12.2% of those with dyspeptic symptoms. There was no significant difference in the rate of H. pylori occurrence between low and high permeability groups. The Glasgow Dyspepsia Severity Score did not differ significantly between H. pylori-positive and -negative patients. Dyspepsia was more frequent and severe in the low permeability group. Dyspepsia in the low permeability group was mostly considered as functional dyspepsia due to the predominance of normal endoscopic findings.
Dyspepsia is a common health problem in approximately half of peritoneal dialysis patients. Dyspepsia observed in those with low peritoneal membrane permeability is generally of functional origin. Furthermore, the frequency and severity of dyspepsia are higher in individuals with low permeability. When planning peritoneal dialysis for these patients, the current status should be taken into consideration, and patients should be informed about necessary precautions and recommendations.
本研究旨在确定腹膜透析患者腹膜通透性与消化不良之间是否存在关系。
本研究纳入了 95 名年龄在 18 岁及以上的腹膜透析患者。根据 2016 年罗马 IV 功能性消化不良诊断标准记录患者消化不良的存在情况。随后，使用格拉斯哥消化不良严重程度评分问卷评估消化不良的严重程度。对于同意排除器质性病变的患者进行内镜检查，或记录最近 2 年内进行的内镜检查结果。此外，检查粪便样本以排除消化不良的器质性原因。使用“PD Adequest”计算机软件计算患者的 PET（腹膜平衡试验）和 Kt/V 值。根据 PET 值将患者分为低和低正常通透性组以及高和高正常通透性组。
所有腹膜透析患者中，消化不良的检出率为 51.6%。所有患者中 H. pylori 阳性率为 11.6%，消化不良症状患者中阳性率为 12.2%。在低和高通透性组中，H. pylori 发生率无显著差异。H. pylori 阳性和阴性患者的格拉斯哥消化不良严重程度评分无显著差异。低通透性组的消化不良更频繁且更严重。低通透性组的消化不良主要被认为是功能性消化不良，因为内镜检查结果大多正常。
消化不良是大约一半腹膜透析患者常见的健康问题。在腹膜通透性较低的患者中观察到的消化不良通常是功能性的。此外，低通透性患者的消化不良频率和严重程度更高。在为这些患者计划腹膜透析时，应考虑当前的状况，并告知患者必要的预防措施和建议。
