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终末期肾病中的胃肠疾病

Gastrointestinal disease in end-stage renal disease.

作者信息

Khan Ayesha, Mushtaq Muhammad, Movva Giri, Sohal Aalam, Yang Juliana

机构信息

Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77550, United States.

Gastroenterology and Hepatology, Creighton University School of Medicine, Phoenix, AZ 85012, United States.

出版信息

World J Nephrol. 2025 Mar 25;14(1):101917. doi: 10.5527/wjn.v14.i1.101917.

Abstract

When kidney function declines to a point where it can no longer maintain life and requires renal replacement therapy ( renal transplant or dialysis), it is called end-stage renal disease (ESRD). Patients with ESRD often experience a range of gastrointestinal (GI) symptoms, with prevalence rates reported as high as 77%-79%. These symptoms and pathologies arise from various factors, including electrolyte imbalance, fluid imbalance, toxin buildup, uremia, medications, dietary and lifestyle restrictions, and the effects of dialysis. GI diseases in patients with renal failure can be further categorized into upper GI, small bowel, and lower GI issues. Common conditions include gastroesophageal reflux disease, nausea and vomiting, dysmotility within the esophagus and stomach, upper GI bleeding, peptic ulcer bleeding, angioectasia, irritable bowel syndrome, mesenteric ischemia, angiodysplasia, diverticular disease, constipation, pancreatitis, and diseases associated with peritoneal dialysis peritonitis and peritoneal stenosis. This review assesses the existing literature on the different GI diseases among individuals with ESRD, shedding light on their pathophysiology and prevalence.

摘要

当肾功能下降到无法维持生命的程度,需要进行肾脏替代治疗(肾移植或透析)时,就称为终末期肾病(ESRD)。ESRD患者常出现一系列胃肠道(GI)症状,报告的患病率高达77%-79%。这些症状和病理状况由多种因素引起,包括电解质失衡、液体失衡、毒素蓄积、尿毒症、药物、饮食和生活方式限制以及透析的影响。肾衰竭患者的胃肠道疾病可进一步分为上消化道、小肠和下消化道问题。常见病症包括胃食管反流病、恶心和呕吐、食管和胃动力障碍、上消化道出血、消化性溃疡出血、血管扩张、肠易激综合征、肠系膜缺血、血管发育异常、憩室病、便秘、胰腺炎以及与腹膜透析相关的腹膜炎和腹膜狭窄等疾病。本综述评估了关于ESRD患者中不同胃肠道疾病的现有文献,阐明了其病理生理学和患病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7852/11755235/2bc291684c0e/101917-g001.jpg

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