Study of Upper Gastrointestinal Endoscopic Findings in Chronic Kidney Disease and Dialysis Patients at Zagazig University Hospitals

Abstract

Background: People with end-stage kidney disease have an unusually high risk of upper gastrointestinal bleeding (UGIB), but no one  knows why. Researchers have looked into the causes and frequency of these lesions using upper GI endoscopy.

Objective: To investigate how often different UGI symptoms and abnormalities detected by endoscopy are in individuals with chronic kidney disease (CKD).

Patients and methods: This cross-sectional study was conducted on a total 116 CKD patients with GIT symptoms. The Clinical Pathology  Department and laboratories of Zagazig University Hospitals followed a specific protocol for the laboratory investigations, which  comprised a full blood count, liver and kidney functions, PT, PTT, and INR. Following an overnight fast, a fiberoptic endoscopic  examination of the upper gastrointestinal tract was carried out.

Results: We found that 65.5% of the patients were G5, 23.3% were G4, and  11.2% were G3. 43.1% of the patients presented with anorexia,  36.2% presented with nausea, 38.8% presented with vomiting, 23.3% presented with heart burn, 20.7% presented with   epigastric pain, 7.8% presented with hiccup, and 14.7% presented with GI bleeding. 39.7% of the patients showed esophagitis, 51.7%  showed gastritis, 14.7% showed duodenitis, 20.7% showed gastric ulcer, 3.7% showed duodenal ulcer, and 7.8% showed hiatus hernia.  There were 15 patients who showed positive H. pylori by biopsy. significant differences were found between the groups regarding  anorexia, vomiting, esophagitis and gastritis (p=0.001, 0.003, 0.044, 0.004 respectively).

Conclusion: Endoscopy on patients with end-stage renal disease (ESRD) can help in early detection of commonly occurring GI lesions and  proper management for prevention of serious complications.