Retrospective Study
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World J Gastroenterol. Aug 28, 2014; 20(32): 11370-11375
Published online Aug 28, 2014. doi: 10.3748/wjg.v20.i32.11370
Gastrointestinal symptoms: A comparison between patients undergoing peritoneal dialysis and hemodialysis
Rui Dong, Zhi-Yong Guo, Jia-Rong Ding, Yang-Yang Zhou, Hao Wu
Rui Dong, Zhi-Yong Guo, Jia-Rong Ding, Yang-Yang Zhou, Hao Wu, Department of Nephrology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Author contributions: Dong R and Guo ZY designed the study; Dong R performed the majority of the study, collected and analyzed the data, and drafted the article; Ding JR, Zhou YY and Wu H participated in data acquisition; Guo ZY provided vital suggestions and interpretation of data, revised the manuscript critically for important intellectual content and give final approval of the version to be published.
Correspondence to: Zhi-Yong Guo, MD, Professor, Department of Nephrology, Changhai Hospital, Second Military Medical University, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China. drguozhiyong@163.com
Telephone: +86-21-31161412 Fax: +86-21-31161418
Received: February 20, 2014
Revised: April 28, 2014
Accepted: July 11, 2014
Published online: August 28, 2014
Abstract

AIM: To compare the prevalence and diversity of gastrointestinal (GI) symptoms in patients undergoing peritoneal dialysis (PD) and hemodialysis (HD).

METHODS: Two hundred and ninety-four end-stage renal disease patients participated in the study, including 182 HD and 112 PD patients. Dimension scores were calculated from a modified gastrointestinal symptom rating scale (GSRS) 18-item questionnaire, including items concerning eating dysfunction, and were used for measuring GI symptoms. Information on patient age, condition contributing to end-stage renal disease and the most recent dialysis adequacy assessment (serum Kt/V urea value) was obtained from the follow-up database and by interviewing patients and/or reviewing the medical records. Differences between the HD and PD groups were evaluated using Student’s t, Pearson’s χ2 or Fisher’s exact tests.

RESULTS: The overall prevalence of GI symptoms, defined by a GSRS > 1, in end-stage renal disease patients was 70.7% (208/294), which differed between HD and PD patients (76.4% vs 61.6%, P < 0.01). HD patients had a higher prevalence of constipation, abdominal pain and diarrhea compared to PD patients (36.3% vs 17.9%, 32.4% vs 5.4%, 17.6% vs 4.5%, respectively, P < 0.05). PD patients had a higher prevalence of reflux compared to HD patients (32.1% vs 24.2%, P < 0.05). Additionally, reflux and eating dysfunction were more severe in PD patients (GSRS: 1.71 ± 1.15 vs 1.30 ± 0.67, 1.57 ± 0.84 vs 1.39 ± 0.61, respectively, P < 0.05), whereas HD patients had greater abdominal pain, diarrhea and constipation (GSRS: 1.22 ± 0.39 vs 1.04 ± 0.19, 1.19 ± 0.53 vs 1.07 ± 0.35, 1.51 ± 0.83 vs 1.23 ± 0.58, respectively, P < 0.05). Finally, 14.8% (27/182) of HD patients presented with more than three GI symptoms, compared to 7.2% (8/112) of PD patients (P < 0.01).

CONCLUSION: HD and PD patients differ in prevalence, severity and diversity of GI symptoms.

Keywords: Gastrointestinal symptom, Hemodialysis, Peritoneal dialysis, End-stage renal disease, Constipation, Reflux, Eating dysfunction, Abdominal pain, Diarrhea, Indigestion

Core tip: End-stage renal disease patients undergoing dialysis frequently experience gastrointestinal symptoms. In agreement with previous studies, a majority of patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) in the present study reported gastrointestinal symptoms. However, the results indicate that the prevalence and severity of various gastrointestinal symptoms differ between patients undergoing these two dialysis treatments. HD patients had a higher prevalence of and more severe constipation, abdominal pain and diarrhea, whereas PD patients experienced stronger and more frequent reflux and eating dysfunction. Furthermore, a significantly greater number of HD patients presented with more than three gastrointestinal symptoms.