A survey of gastrointestinal symptoms in peritoneal dialysis patients and hemodialysis patients

Objective To investigate the gastrointestinal symptoms in peritoneal dialysis (PD) patients and hemodialysis (HD) patients.Methods Eighty-nine PD patients (PD group) and 102 HD patients (HD group) in Department of Nephrology between July to August in 2015 were recruited in this study. The incidence and severity of gastrointestinal symptoms were assessed by the (gastrointestinal symptom rating scale, GSRS) and Gastroesophageal Reflux Disease Questionnaire (GerdQ). Patients' age, gender, duration of dialysis, history of diabetes, smoking, taking glucocorticoid and nonsteroidal anti-inflammatory drugs were recorded. Body mass index (BMI), blood hemoglobin (Hb), corrected calcium (cCa), phosphorus, intact parathyroid hormone (iPTH), serum albumin (Alb), serum creatinine (SCr), blood urea nitrogen (BUN) and Kt/V were collected. Using T test and Chi-square test, the data were compared between two groups, and the main influencing factors of gastrointestinal symptoms were screened out by stepwise multiple regression analysis.Results There was no statistically significant difference in age, gender, duration of dialysis, history of diabetes, smoking, taking glucocorticoid and nonsteroidal anti-inflammatory drugs between PD and HD groups. But the levels of serum albumin, BUN and achieving the goal of Kt/V were higher in HD group than in PD group. The prevalence of troublesome gastrointestinal symptoms (GSRS >1) was 83.1% for PD, and 82.4% for HD. The mean GSRS scores in PD group were higher than in HD group (4.7±4.3 vs. 3.8±3.3, P=0.004). The occurrence rate of heart burn (P=0.029), reflux (P=0.001), nausea and vomiting (P=0.004) was higher in PD group than in HD group. Sixteen patients (18%) in PD group had determined gastroesophageal reflux by GerdQ, which was significantly higher than in HD group (8 patients, 7%). Stepwise multiple regression analysis revealed BMI was positively correlated to GSRS scores in dialysis patients (B=0.28, P=0.005), while hemoglobin was negatively correlated to GSRS (B=-0.057, P=0.002).Conclusions Dialysis patients had a high prevalence of gastrointestinal symptoms. PD patients were particularly outstanding in gastroesophageal reflux symptoms. Gastrointestinal symptoms were related to BMI and hemoglobin.