title: Prevalence of gastroesophageal reflux disease symptoms and effects of esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis.
abstract: BACKGROUND
  The prevalence of gastroesophageal reflux disease (GERD) symptoms has not been investigated in patients on maintenance hemodialysis in Japan, and few studies have reported the effect of proton pump inhibitors (PPIs) in hemodialysis patients with GERD symptoms. Here, we investigated the prevalence of GERD symptoms and the effects of the PPI esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis.
  
  
  METHODS
  This was a cross-sectional/cohort study of hemodialysis outpatients implemented in 10 Japanese medical facilities from October 2012 to March 2014. The trial was registered in the UMIN Clinical Trial Registry (UMIN000009124).
  
  
  RESULTS
  Forty-one of 385 patients (11%) reported GERD symptoms on the Global Overall Symptom (GOS) questionnaire. Multivariate logistic regression analysis identified the independent prognostic factors for GERD symptoms as a history of gastric ulcer and use of sevelamer hydrochloride or calcium polystyrene sulfonate. Participants with GERD symptoms completed the Quality of Life in Reflux and Dyspepsia, Japanese version (QOLRAD-J) questionnaire and were assigned to receive 4-week esomeprazole treatment (20 mg/day). This PPI therapy significantly improved all QOLRAD-J domains in the full analysis set (n = 28) and improved the GERD symptoms listed in the GOS questionnaire. Significantly impaired disease-specific quality of life (QOL) in the QOLRAD-J domains was observed in 44.4-74.1% of patients who had symptoms before treatment. The mean GOS and QOLRAD-J scores correlated significantly.
  
  
  CONCLUSIONS
  Therapy with 20 mg/day esomeprazole appears to be efficacious for improving disease-specific QOL and GERD symptoms in Japanese patients on maintenance hemodialysis.
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan. tnamikoshi@med.kawasaki-m.ac.jp.
authors.forename: Tamehachi
authors.initials: T
authors.lastname: Namikoshi
authors.affiliation: Department of Internal Medicine, Kasaoka Daiichi Hospital, Kasaoka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Internal Medicine, Satou Memorial Hospital, Shoo, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Hatta
authors.affiliation: Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Tokura
authors.affiliation: Department of General Internal Medicine 1, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Oshiro
authors.affiliation: Nishizaki Internal Medicine Clinic, Kurashiki, Japan.
authors.forename: Tetsuichi
authors.initials: T
authors.lastname: Nishizaki
authors.affiliation: Obata Medicine Clinic, Tsuyama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Obata
authors.affiliation: Sanyo Nephro Clinic, Fukuyama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mori
authors.affiliation: Fueki Naika Clinic, Okayama, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Fueki
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Sohachi
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Yoshisuke
authors.initials: Y
authors.lastname: Haruna
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kuwabara
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yorimitsu
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Ihoriya
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kadoya
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Itano
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Komai
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Tamaki
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Nephrology and Hypertension, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kashihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004415:Dyspepsia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D064098:Esomeprazole / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life; D012074:Remission Induction; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D064098:Esomeprazole
keywords: Gastroesophageal reflux disease; Hemodialysis; Proton pump inhibitors; Quality of life; Questionnaires