Gastroesophageal reflux disease in chronic renal failure patients with upper GI symptoms: multivariate analysis of pathogenetic factors.
OBJECTIVE
The association between gastroesophageal reflux disease and end-stage renal disease remains unclear. We aimed to assess the prevalence of gastroesophageal reflux disease and also to identify possible pathogenetic factors in the development of reflux in symptomatic end-stage renal disease patients.


METHODS
The study involved 42 end-stage renal disease patients with upper GI symptoms (group I) and 46 age- and sex-matched controls who did not have renal disease but had the same symptoms (group II). Endoscopy, endoscopic biopsies, and 24-h esophageal pH studies were used to diagnose gastroesophageal reflux disease. Subjects were also investigated for Helicobacter pylori gastritis and GI amyloidosis.


RESULTS
The prevalences of gastroesophageal reflux disease in the two groups were similar (81% vs 84.8%, p = 0.423). The prevalence of H. pylori infection was significantly lower in group I than in group II (38.1% vs 67.4%, p = 0.01). There were II cases of GI amyloidosis in group I. Multivariate logistic regression analysis in group I showed that GI amyloidosis (OR = 7.28, 95% CI = 1.13-46.93), chronic ambulatory peritoneal dialysis treatment (OR = 5.54, 95% CI = 1.01-30.43), and absence of H. pylori infection (OR = 3.75, 95% CI = 1.01-13.9) were significantly associated with reflux esophagitis.


CONCLUSIONS
Upper GI symptoms are important in predicting gastroesophageal reflux disease in end-stage renal disease patients. Chronic ambulatory peritoneal dialysis, GI amyloidosis, and absence of H. pylori infection seem to be risk factors for the development of gastroesophageal reflux disease in end-stage renal disease patients.
Cekin
Ayhan Hilmi
AH
Department of Gastroenterology, Baskent University School of Medicine, Ankara, Turkey.
Boyacioglu
Sedat
S
Gursoy
Murat
M
Bilezikci
Banu
B
Gur
Gurden
G
Akin
Ebru Dogan
ED
Ozdemir
Nurhan
N
Yilmaz
Ugur
U
D000328:Adult; D000686:Amyloidosis / Q000150:complications / Q000453:epidemiology; D004941:Esophagitis / Q000150:complications / Q000382:microbiology / Q000473:pathology; D004947:Esophagus / Q000378:metabolism; D005260:Female; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000150:complications*; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors
D005755:Gastrins