Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities

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.

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.

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.

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.