Peritoneal dialysis patients have higher prevalence of gastrointestinal symptoms than hemodialysis patients.
OBJECTIVE
Malnutrition is common in dialysis patients and is attributed to decreased food intake, and/or chronic systemic inflammation linked to dialysis-related comorbidities and complications. This study aimed to determine the prevalence of gastrointestinal (GI) symptoms in dialysis patients and whether this impacts food intake.


METHODS
Cross-sectional study.


METHODS
Tertiary teaching hospital.


METHODS
All consenting hospital peritoneal dialysis (PD) and hemodialysis (HD) patients.


METHODS
Patients were interviewed by a dietitian regarding the prevalence and impact of GI symptoms (nausea, vomiting, bloating, early satiety, diarrhea, heartburn, fatigue, and weight changes). Serum levels of albumin were measured, and the use of medication known to cause GI symptoms was recorded.


METHODS
Presence of GI symptoms.


RESULTS
The PD (n = 122) and HD (n = 172) groups were similar in age, gender, and presence of diabetes. Serum albumin levels were lower for those on PD compared with HD (3.2 vs. 3.5 g/dL, P < .001). Eighty-five percent of the patients on PD reported at least 1 GI symptom, compared with 51% on HD. Compared with HD, more PD patients reported that GI symptoms were related to the onset of dialysis (55% vs. 12%, P < .001). A greater number of PD patients (compared with HD patients) reported a decrease in food intake (53% vs. 14%, P < .001) and that they had attempted dietary changes to alleviate symptoms (34% vs. 9%, P < .001).


CONCLUSIONS
These results should influence dietetic educational practice. In addition to the provision of adequate protein and energy, dialysis patients should be counselled regarding the management of GI symptoms and monitored for the prevalence and severity of these symptoms.
Department of Dietetics, Monash Medical Centre, Southern Health, Clayton, Victoria, Australia. karen.salamon@southernhealth.org.au
Karen
K
Salamon
Julie
J
Woods
Eldho
E
Paul
Catherine
C
Huggins
D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000503:physiopathology; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin