Agustos 2020

Kronik böbrek yetmezligi tanili hastalarda üst gastrointestinal sisteme ait endoskopik ve histolojik bulgularin değerlendirilmesi

Kronik böbrek yetmezligi tanili hastalarda üst gastrointestinal sisteme ait endoskopik ve histolojik bulgularin degerlendirilmesi

  • Ana Sayfa
  • Sayılar
  • Agustos 2020
  • Kronik böbrek yetmezligi tanili hastalarda üst gastrointestinal sisteme ait endoskopik ve histolojik bulgularin değerlendirilmesi...
Yazarlar
Sami FIDAN1, Nurullah ÜZÜM2, Muammer CANSIZ3, Murat ERKUT1, Arif Mansur COSAR1
Kurumlar
Karadeniz Teknik Üniversitesi, Tip Fakültesi, 1Gastroenteroloji Bilim Dali, 2Iç Hastaliklari Ana Bilim Dali, 3Nefroloji Bilim Dali, Trabzon
Sayfa Numaraları
57-62
Makale Türü
Özgün Arastirma
Anahtar Kelimeler
Background and Aims: Symptoms occurring in the upper gastrointestinal tract are common among patients with chronic kidney disease. This study aimed to assess the endoscopic and histological findings in the upper gastrointestinal tract of patients with chronic kidney disease. Materials and Methods: We retrospectively evaluated the data of patients with chronic kidney disease who underwent follow up examinations in our hospital between January 2013 and December 2018 and who underwent endoscopy, regardless of the etiology. Patients were categorized according into the following three groups: hemodialysis, continuous ambulatory peritoneal dialysis, and nondialysis. Results: We studied the data of 493 patients (mean age, 57.02 ± 16.3 years, 64.1% men), of which 270 were categorized in the hemodialysis, 34 in continuous ambulatory peritoneal dialysis, and 189 in the nondialysis groups. Abnormal endoscopic findings were detected in 83% of the patients, and the rates of these findings were similar for the three groups, i.e., the hemodialysis groups showed a rate of 83.7%, continuous ambulatory peritoneal dialysis showed 73.5%, and nondialysis group showed 83.6% (P = 0.317). The most common endoscopic finding in all patients was gastritis (67.7%). Total 320 patients underwent histological evaluation. Helicobacter pylori infection, intestinal metaplasia, and gastric cancer rates for the hemodialysis, continuous ambulatory peritoneal dialysis, and nondialysis groups were 24%, 26.6%, and 0.9%, respectively. Conclusion: Most patients with chronic kidney disease have disorders of the upper gastrointestinal tract. Since premalignant gastric lesions are common in these patients, endoscopic evaluation is an acceptable procedure, particularly in those awaiting kidney transplantation
Keywords
Chronic kidney disease, Helicobacter pylori, hemodialysis, endoscopy, endoscopic findings

Özet

Giriş ve Amaç: Kronik böbrek yetmezligi olan hastalarda üst gastrointestinal sistem bulgulari oldukça sik görülmektedir. Bu çalışmada kronik böbrek yetmezligi olan hastalarda üst gastrointestinal sisteme ait endoskopik ve histolojik bulgularının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Hastanemizde Ocak 2013 ile Aralık 2018 tarihleri arasında kronik böbrek yetmezligi tanısı ile takip edilen ve herhangi bir nedenle endoskopi yapılan Hastaların sonuçları retrospektif olarak de- gerlendirildi. Hastalar hemodiyalize alinanlar, sürekli ayaktan periton diyalizi yapılanlar ve diyalize girmeyenler olarak gruplandirildi. Bulgular: çalışmaya toplam 493 hasta dahil edildi (yaş ortalaması 57.02±16.3, %64.1 erkek). Hastaların 270’i hemodiyaliz, 34’ü sürekli ayaktan periton diyalizi ve 189 tanesi ise diyalize girmeyen gruptaydi. Hastaların %83’ünde anormal endoskopik bulgu saptandi. Gruplar arasında anormal endoskopik bulgu saptanma orani benzerdi (hemodiyaliz; %83.7, periton diyalizi; %73.5, diyalize girmeyenler; %83.6, p:0.317). Her üç hasta grubunda En sık görülen endoskopik bulgu gastrit idi (%67.7). Histolojik değerlendirme yapılan 320 hastanın %24’ünde Helicobacter pylori pozitifliği, %26.6’sında intestinal metaplazi ve %0.9’unda mide kanseri tespit edildi. Sonuç: Kronik böbrek yetmezligi tanıli Hastaların büyük çogunlugunda üst gastrointestinal sisteme ait patolojiler görülmektedir. Bu hastalarda premalign gastrik lezyonlar sik görüldügü için özellikle böbrek nakli planlanan hastalarda endoskopik değerlendirme kabul edilebilir bir prosedürdür

Abstract

Background and Aims: Symptoms occurring in the upper gastrointestinal tract are common among patients with chronic kidney disease. This study aimed to assess the endoscopic and histological findings in the upper gastrointestinal tract of patients with chronic kidney disease. Materials and Methods: We retrospectively evaluated the data of patients with chronic kidney disease who underwent follow up examinations in our hospital between January 2013 and December 2018 and who underwent endoscopy, regardless of the etiology. Patients were categorized according into the following three groups: hemodialysis, continuous ambulatory peritoneal dialysis, and nondialysis. Results: We studied the data of 493 patients (mean age, 57.02 ± 16.3 years, 64.1% men), of which 270 were categorized in the hemodialysis, 34 in continuous ambulatory peritoneal dialysis, and 189 in the nondialysis groups. Abnormal endoscopic findings were detected in 83% of the patients, and the rates of these findings were similar for the three groups, i.e., the hemodialysis groups showed a rate of 83.7%, continuous ambulatory peritoneal dialysis showed 73.5%, and nondialysis group showed 83.6% (P = 0.317). The most common endoscopic finding in all patients was gastritis (67.7%). Total 320 patients underwent histological evaluation. Helicobacter pylori infection, intestinal metaplasia, and gastric cancer rates for the hemodialysis, continuous ambulatory peritoneal dialysis, and nondialysis groups were 24%, 26.6%, and 0.9%, respectively. Conclusion: Most patients with chronic kidney disease have disorders of the upper gastrointestinal tract. Since premalignant gastric lesions are common in these patients, endoscopic evaluation is an acceptable procedure, particularly in those awaiting kidney transplantation

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