Dyspepsia among patients with chronic kidney disease: a cross sectional study

BACKGROUNDS: Dyspepsia is a condition that affects 25% of the U.S. population, and, when associated with pyrosis, its prevalence reaches 40%. Patients with chronic renal insufficiency not only present higher circulating levels of gastrin and gastric dysmotilty, but also make use of a great amount of drugs for the treatment of their comorbidities. This situation increases the chances of developing gastrointestinal symptoms. The aim of the current study is to evaluate the dyspeptic disease profile in patients undergoing hemodialysis, comparing them with chronic renal disease patients in conservative treatment and non-renal injury patients. METHODS: This is a cross sectional study performed at the Gastroenterology department at Faculdade de Medicina do ABC in São Paulo, Brazil. Three groups were set aside according to the renal function levels calculated using the simplified MDRD formula. They answered three questionnaires that evaluated the presence of dyspepsia, functional dyspepsia and gastroesophageal reflux disease (GERD) associated with the performance of high digestive endoscopy. RESULTS: A significant difference between the groups was observed concerning the renal function evaluated by the rates of creatinine clearance, creatinine and urea (p < 0.001). The rate of dyspepsia in the control group was higher than in patients with renal function alterations (p = 0.014). There was no difference between groups when it came to the presence of functional dyspepsia and GERD. However, there was a higher use of proton pump inhibitors in the hemodialysis group than in the other groups (p < 0.001). CONCLUSION: In the proposed model, there was no positive correlation between the worsening of the renal function and the presence of dyspepsia, functional dyspepsia and GERD. The longitudinal evaluation of hemodialysis patients is hampered by the high mortality rates in this group. There was a higher use of proton pump inhibitors, and it is believed that the dyspeptic symptoms are not acid-related.