Volaemic status and dyspepsia in end-stage renal disease patients

Studies in animals show a relationship between extracellular volume and gastrointestinal motility. End-stage renal disease (ESRD) patients present fluid overload and frequent dyspeptic symptoms. We looked for an association between volaemic status and dyspepsia among ESRD patients undergoing haemodialysis (HD).

We studied 155 ESRD patients on HD. Their volaemic status was evaluated using bioimpedance analysis. Fluid overload (FO) in litres and relative fluid overload (rFO) in percentage were calculated. rFO > 15% was classified as hypervolaemia. Dyspepsia was assessed through the Porto Alegre Dyspeptic Symptoms Questionnaire (PADYQ). PADYQ scores equal to or greater than 6 classified patients as dyspeptic. Characteristics of patients with and without dyspepsia were compared. Pearson's test was used to test the correlation between continuous variables. Multivariate linear and logistic regressions were performed to test FO as predictor of dyspepsia score and the presence of dyspepsia.

There were 64 (41.2%) patients with dyspepsia. Dyspeptics presented higher FO (2.5 ± 1.8 L vs 1.0 ± 1.8 L; P < 0.001) and higher rFO (16 ± 9.9% vs 4.8 ± 12.0%; P < 0.001). Dyspepsia score was positively correlated with FO (r = 0.300; P < 0.001) and with rFO (r = 0.256; P = 0.001). There were more patients with hypervolaemia among dyspeptics compared to non-dyspeptics (65.6% vs 17.6%; P < 0.001). FO was an independent predictor of dyspepsia score (b = 1.036; P < 0.001) and the presence of dyspepsia (OR = 2.00, 95% CI = 1.55-2.50; P < 0.001).

Hypervolaemia is associated with dyspepsia among ESRD patients on HD.