Yuan D, Wang XQ, Shao F, Zhou JJ, Li ZX. Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia. World J Gastrointest Surg 2024; 16(7): 2157-2166 [PMID: 39087119 DOI: 10.4240/wjgs.v16.i7.2157]
Corresponding Author of This Article
Zhong-Xin Li, MD, Doctor, Department of Nephrology, Beijing Luhe Hospital Affiliated to Capital Medical University, No. 82 Xinhua South Road, Tongzhou District, Beijing 101100, China. lhyy6806@ccmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2157-2166 Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2157
Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia
Dan Yuan, Xiao-Qi Wang, Feng Shao, Jing-Jing Zhou, Zhong-Xin Li
Dan Yuan, Xiao-Qi Wang, Feng Shao, Jing-Jing Zhou, Zhong-Xin Li, Department of Nephrology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing 101100, China
Author contributions: Yuan D, Wang XQ, Shao F, Zhou JJ, and Li ZX contributed equally to this work; Yuan D and Wang XQ designed the research study; Shao F and Zhou JJ performed the primary literature and data extraction; Yuan D and Wang XQ analyzed the data and wrote the manuscript; Li ZX was responsible for revising the manuscript for important intellectual content; All authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by the Beijing Luhe Hospital, Capital Medical University Institutional Review Board.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare having no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at lhyy6806@ccmu.edu.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Xin Li, MD, Doctor, Department of Nephrology, Beijing Luhe Hospital Affiliated to Capital Medical University, No. 82 Xinhua South Road, Tongzhou District, Beijing 101100, China. lhyy6806@ccmu.edu.cn
Received: April 10, 2024 Revised: May 11, 2024 Accepted: June 14, 2024 Published online: July 27, 2024 Processing time: 103 Days and 0.1 Hours
Abstract
BACKGROUND
Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis, and these symptoms seriously affect patients' prognosis.
AIM
To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.
METHODS
We retrospectively selected 98 patients with uremia who underwent regular hemodialysis treatment in the blood purification center of our hospital from December 2022 to December 2023. The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale (GSRS). Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms. The factors that may affect gastrointestinal symptoms were identified by single-factor analysis. Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.
RESULTS
Gastrointestinal symptoms included indigestion, constipation, reflux, diarrhea, abdominal pain, and eating disorders, and the total average GSRS score was 1.35 ± 0.47. This study showed that age, number of tablets, dialysis time, glucocorticoid, parathyroid hormone (PTH), combined diabetes mellitus and C-reactive protein (CRP) were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis, whereas body mass index (BMI), hemoglobin (Hb), and urea clearance index were independent protective factors (P < 0.05).
CONCLUSION
Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis, most commonly including dyspepsia, eating disorders, and gastroesophageal reflux. The independent influencing factors mainly include the BMI, age, number of pills taken, dialysis time, urea clearance index, Hb, use of glucocorticoids, and thyroid hormone level. PTH, CRP, and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms, and targeted prevention can be performed.
Core Tip: Gastrointestinal symptoms in hemodialysis patients with uremia seriously affects patients' quality of life. This study showed that the independent influencing factors related to the occurrence of gastrointestinal symptoms were mainly body mass index, age, number of tablets, dialysis time, urea clearance index, hemoglobin, use of glucocorticoid, parathyroid hormone, C-reactive protein, and diabetes mellitus. In clinical practice, variable factors can be controlled for prophylaxis.
