Gastrointestinal Evaluation in Chronic Kidney Diseases

Abstract

Background: Upper gastrointestinal (GI) symptoms are common in patients with severe chronic renal failure. The aim of this prospective study is to determine the prevalence of GI abnormalities and Helicobacter pylori (H. pylori) infection and assess the importance of GI evaluation among in pretransplantation with CKD patients Material and Methods: Between August 2008 and July 2010, 287 patients with CKD who were candidates for renal transplantation were included for the study. Endoscopic changes were described and multiple antral gastric biopsies were taken for detection of H. pylori infection. Gastric biopsy findings were compared to findings in 100 consecutive patients with normal renal function undergoing endoscopy for assessment of dyspepsia. Results: There were 197 males 90 females. The Mean age was 36.7 years. Duration of hemodialysis treatment prior to endoscopy was 17 ± 12.3 months. Symptoms of GI disturbance were found in 82(28.6%) of the 287 patients. In the 172 patients with endoscopic abnormalities, there were 49 asymptomatic and 123 symptomatic cases (P<0.001). Helicobacter pylori were present in 78 patients in the dialysis patients versus 29 in the control group. Conclusion: Upper GI abnormalities are common among CKD patients. Gastric erosions, esophagitis, antral erosion are common lesions in these patients. There is no association between patient symptoms and these lesions. There were no relation between H.pylori and symptoms. These patients should undergo endoscopic evaluation periodically and they should be treated prior to ultimate renal transplantation.