The prevalence of gastroesophageal reflux disease and reflux esophagitis in dialysis patients: between facts and fiction

The prevalence of antral H pylori was significantly less in patients with renal disease (12, 24%) than in the control group (51, 42%), but was associated with a similar active chronic inflammatory reaction with prominent lymphoid follicles. The prevalence of the bacteria in patients with renal disease was similar to that reported in normal volunteers, and was the same whether the patients had upper gastrointestinal symptoms or not. This low prevalence may be related to the wide variety of medication, including antibiotics, which these patients are prescribed during the course of their illness. Gastroesophageal Reflux Disease (GERD), also called acid reflux, is a common upper gastrointestinal disorder in people with Chronic Kidney Disease (CKD).

The causes of the increase in GERD may include delayed gastric emptying owing to altered myoelectric activity, or perhaps to an increased production of gastric acid, but evidence for the latter is small. Importantly, treating the problem may lead to better nutrition and higher albumin levels, thus improving patient prognosis. Dyspepsia and GORS leading to PPI treatment are common in CRF patients on dialysis.

An Arizona man indicates that he had to undergo dialysis treatment and kidney transplant surgery due to the side effects of Nexium, indicating that long-term use of the popular heartburn drug caused him to develop chronic kidney disease (CKD) and other kidney damage. The prevalence of GI symptoms in ESRD patients is well described.

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But past research has linked the drugs to cases of acute kidney inflammation, he said. It’s possible, he added, that some PPI users develop cases that go undiagnosed and eventually lead to chronic kidney disease. Few study patients — less than 0.2 percent — developed end-stage kidney failure. But the odds were almost doubled among PPI users, the study found.

Vesicoureteral reflux (VUR) can also cause an infection, because bacteria can develop in the urine. Without treatment, kidney damage may occur. Read more about how your pharmacist can advise you about over-the-counter medicines and kidney disease. Some, such as St John’s Wort (for low mood), can interact with medicines prescribed for kidney disease. Avoid herbal medicines if you have kidney disease as they can raise blood pressure.

They found twice-daily use was associated with a 46 percent increased risk of chronic kidney disease, versus a 15 percent increased risk in those taking one daily dose. People who use proton pump inhibitors (PPIs) have a 20 percent to 50 percent higher risk of chronic kidney disease compared with nonusers, said lead author Dr. Morgan Grams, an assistant professor of epidemiology at Johns Hopkins University in Baltimore.

Some people can reduce GERD symptoms by losing weight (if overweight) and wearing loose-fitting clothing around the stomach area because tight clothing can constrict the area and increase reflux. Dietary changes that can help reduce symptoms which include decreasing fat intake and eating small, frequent meals instead of three large ones. Those with CKD who are overweight should talk with their Dietitian regarding dietary changes that can alleviate GERD BEFORE enacting any changes themselves. Additionally, remaining upright for 3 hours after meals can help combat symptoms of acid reflux and raising the head of your bed 6 to 8 inches by securing wood blocks under the bedposts can also help. Just using extra pillows may not be effective.

Overuse of acid suppressant drugs in patients with chronic renal failure.

The findings appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). His team found that PPI users were more likely than people on other heartburn medications to develop chronic kidney disease or kidney failure over five years. Over time, chronic kidney disease can lead to kidney failure, forcing someone to undergo regular dialysis and possibly a kidney transplant, according to the U.S.

Heartburn is a symptom, and people who suffer heartburn more than twice a week may have GERD, the institute says. A key problem is that many people take PPIs when they’re unnecessary, or take them for too long, said Dr. F. Paul Buckley. He is surgical director of the Heartburn & Acid Reflux Center at the Scott & White Clinic, in Round Rock, Texas. In this new study, researchers used data on self-reported proton pump inhibitors use among more than 10,000 people taking part in a national study on hardening of the arteries. The researchers also evaluated data on outpatient PPI prescriptions among nearly 250,000 patients of a health care system in Pennsylvania.

Prescription drug information for the preceding 3 years was gathered from Medicare Part D claims. Among patients with kidney failure on dialysis, use of proton pump inhibitors was associated with a 19% higher risk of hip fracture. The association remained within subgroups of low, moderate, and high use, yielding of 16%, 21%, and 19% greater risks, respectively.

CKD5-ND patients also suffered from poorer appetite compared to ESRD patients, likely from uncorrected uremia and poorer psychosocial mental state (usually arising from anxiety from having to start dialysis soon). Like the dialysis population, CKD5-ND patients experienced more overall GI symptoms and had poorer appetite than controls.

Our literature review from pub med revealed 8 studies investigating the differences between these two groups of patients (Table 5). The general feeling was that PD patients were more likely to get reflux symptoms [10-14]. HD patients, on the other hand had more constipation [10,14] and abdominal pain [8,15]. This study confirmed the association of abdominal pain with HD, but not other symptoms.

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