Document Detail

Endoscopic findings in end-stage renal disease.
MedLine Citation:
PMID:  12783348     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIMS: Patients with end-stage renal disease (ESRD) may demonstrate a number of gastrointestinal lesions and suffer subsequent complications. Our aim was to investigate the endoscopic findings in these patients and identify the predisposing factors. PATIENTS AND METHODS: During a 1-year period (February 2000 to January 2001), we studied consecutive patients with end-stage renal disease who were undergoing routine endoscopy before renal transplantation. The rapid urease test was also performed to detect Helicobacter pylori infection. Demographic and clinical data were collected. Logistic regression analysis was used to determine the risk factors for important endoscopic lesions, including esophagitis, gastroduodenal erosions, and peptic ulcers. RESULTS: We studied 206 patients (124 male, 82 female, mean age 38.9). Of the patients 73.8% were asymptomatic but some patients experienced nausea (12.6%), heartburn (8.7%), and abdominal pain (7.3%). Endoscopy was normal in 74 patients (35.9%). Abnormal endoscopic findings were duodenal erosions (32.0%), antral erosions (22.8%), diffuse antral erythema (27.8%), duodenal ulcer (7.3%), esophagitis (5.8%), angiodysplasia (4.4%), nodular duodenum (2%), and inflammatory gastric polyps (1.5%). The rapid urease test was positive in 58.8% of patients. Important endoscopic lesions were more common in men and in H. pylori-infected patients. Age, duration of dialysis, cause of the ESRD, presence of any symptoms, and hemoglobin levels were not found to be related to these lesions. Most patients with peptic ulcers were asymptomatic. CONCLUSIONS: Duodenal erosions (32.0%), gastric erosions (22.8%), diffuse antral erythema (27.8%) and duodenal ulcer (7.3%) are common lesions in patients with end-stage renal disease. Male gender and H. pylori infection are associated with a higher risk of these lesions. As there is no association between patients' symptoms and gastroduodenal lesions, which may increase the risk of post-transplant complications, the development of diagnostic strategies for the detection of these lesions is recommended.
R Sotoudehmanesh; A Ali Asgari; R Ansari; M Nouraie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endoscopy     Volume:  35     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-03     Completed Date:  2003-12-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  502-5     Citation Subset:  IM    
Digestive Diseases Research Center, Tehran University of Medical Sciences, Shariati Hospital, North Kargar Avenue, Tehran 14114, Iran.
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MeSH Terms
Duodenal Ulcer / diagnosis,  etiology
Endoscopy, Gastrointestinal*
Helicobacter pylori / isolation & purification
Kidney Failure, Chronic / blood,  complications*,  physiopathology
Middle Aged
Multivariate Analysis
Stomach Ulcer / diagnosis,  etiology
Urease / analysis
Reg. No./Substance:

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