Agustos 2020
Kronik böbrek yetmezligi tanili hastalarda üst gastrointestinal sisteme ait endoskopik ve histolojik bulgularin degerlendirilmesi
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 degerlendirilmesi...
Özet
Giris ve Amaç: Kronik böbrek yetmezligi olan hastalarda üst gastrointestinal sistem bulgulari oldukça sik görülmektedir. Bu çalismada kronik böbrek yetmezligi olan hastalarda üst gastrointestinal sisteme ait endoskopik ve histolojik bulgularinin degerlendirilmesi amaçlanmistir. Gereç ve Yöntem: Hastanemizde Ocak 2013 ile Aralik 2018 tarihleri arasinda kronik böbrek yetmezligi tanisi ile takip edilen ve herhangi bir nedenle endoskopi yapilan hastalarin sonuçlari retrospektif olarak de- gerlendirildi. Hastalar hemodiyalize alinanlar, sürekli ayaktan periton diyalizi yapilanlar ve diyalize girmeyenler olarak gruplandirildi. Bulgular: Çalismaya toplam 493 hasta dahil edildi (yas ortalamasi 57.02±16.3, %64.1 erkek). Hastalarin 270’i hemodiyaliz, 34’ü sürekli ayaktan periton diyalizi ve 189 tanesi ise diyalize girmeyen gruptaydi. Hastalarin %83’ünde anormal endoskopik bulgu saptandi. Gruplar arasinda 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 sik görülen endoskopik bulgu gastrit idi (%67.7). Histolojik degerlendirme yapilan 320 hastanin %24’ünde Helicobacter pylori pozitifligi, %26.6’sinda intestinal metaplazi ve %0.9’unda mide kanseri tespit edildi. Sonuç: Kronik böbrek yetmezligi tanili hastalarin büyük çogunlugunda üst gastrointestinal sisteme ait patolojiler görülmektedir. Bu hastalarda premalign gastrik lezyonlar sik görüldügü için özellikle böbrek nakli planlanan hastalarda endoskopik degerlendirme 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
