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Factors associated with irritable bowel syndrome symptoms in hemodialysis patients
Bartosz Fiderkiewicz, Alicja Rydzewska-Rosołowska, Michał Myśliwiec, Magdalena Birecka, Bożenna Kaczanowska, Grażyna Rydzewska, Andrzej Rydzewski
Bartosz Fiderkiewicz, Andrzej Rydzewski, Department of Internal Medicine, Nephrology and Transplantation Medicine, Central Clinical Hospital of Ministry of Home Affairs, 02-507 Warsaw, Poland
Alicja Rydzewska-Rosołowska, Michał Myśliwiec, Department of Nephrology and Transplantation Medicine, Medical University, 15-540 Białystok, Poland
Magdalena Birecka, Niepubliczny Zakład Opieki Zdrowotnej Diaverum Polska Sp. z o.o., 02-325 Warsaw, Poland
Bożenna Kaczanowska, NZOZ Centrum Dializa Sosnowiec, Department Pruszków, 05-800 Pruszków, Poland
Grażyna Rydzewska, Department of Internal Medicine and Gastroenterology, Central Clinical Hospital of Ministry of Home Affairs, 02-507 Warsaw, Poland
Grażyna Rydzewska, Andrzej Rydzewski, Department of Surgical Research and Transplantation Medicine, Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland
Grażyna Rydzewska, Andrzej Rydzewski, The Jan Kochanowski, University of Humanities and Sciences, Faculty of Health Studies, 25-317 Kielce, Poland
Author contributions: Fiderkiewicz B, Rydzewska G and Rydzewski A designed the study; Fiderkiewicz B, Rydzewska-Rosołowska A, Myśliwiec M, Birecka M, Kaczanowska B, Rydzewska G and Rydzewski A performed the study; Fiderkiewicz B, Rydzewska G and Rydzewski A analyzed the data; Fiderkiewicz B, Rydzewska-Rosołowska A and Rydzewski A wrote the paper.
Correspondence to: Andrzej Rydzewski, MD, PhD, Department of Internal Medicine, Nephrology and Transplantation Medicine, Central Clinical Hospital of Ministry of Home Affairs, Warsaw, Wołoska 137, 02-507 Warsaw, Poland. arydzew@ujk.edu.pl
Telephone: +48-22-5081200 Fax: +48-22-5081218
Received: August 19, 2010
Revised: October 5, 2010
Accepted: October 12, 2010
Published online: April 21, 2011
AIM: To investigate clinical characteristics associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients.
METHODS: This was a cross-sectional study. A questionnaire based on the Bowel Disease Questionnaire that records gastrointestinal symptoms was given to 294 patients in 4 dialysis centers. A total of 196 (67%) subjects returned the survey. A multivariable logistic regression model was used to identify factors significantly associated with IBS symptoms.
RESULTS: Symptoms compatible with IBS were present in 27 (13.8%) subjects and independently associated with low post-dialysis serum potassium [OR = 0.258, 95% CI (0.075-0.891), P = 0.032], paracetamol use [OR = 3.159, 95% CI (1.214-8.220), P = 0.018], and Kidney Disease Quality of Life (KDQOL) cognitive function score [OR = 0.977, 95% CI (0.956-0.999), P = 0.042]. Univariate regressions were also performed and the reported significance is for multivariate analysis. No association was detected for age, gender, depressed mood, smoking (present or past), body mass index, albumin level, Kt/V, sodium pre- or post-dialysis level, change in potassium level during HD, proton pump inhibitor or H2 blocker use, aspirin use, residual diuresis, hepatitis B or C infection, diabetes mellitus, marital status and education level.
CONCLUSION: This study examined potential risk factors for symptoms compatible with IBS in HD patients and identified an association with paracetamol use, post-dialysis potassium level and KDQOL-cognitive function score.
