Upper Gastrointestinal Disorders Among Dialysis Patients

Abstract

ABSTRACT The prevalence of co-morbid gastrointestinal symptoms is high in dialysis patients, and dyspeptic symptoms, such as nausea, vomiting, and epigastric burning are the most common symptoms. Upper gastrointestinal disorders (e.g., peptic ulcer disease and gastroparesis) underlie most of these symptoms, while less common but severe complications are also likely that include gastrointestinal bleeding from gastric antral vascular ectasia, erosions or ulcers. Incidence of gastrointestinal disorders is considered to increase with the duration of renal failure, independent of dialysis modality. While uremia and dialysis have been linked to an increased risk of gastrointestinal tract lesions, pathogenesis of gastrointestinal dysfunction in end-stage renal disease is considered to be multifactorial and has not yet been clarified. In addition, conflicting data exist on the association of renal dysfunction with gastrointestinal disorders, and there are no explicit guidelines for the management of co-morbid gastrointestinal problems in patients with concomitant renal failure. Herein, we review the common upper gastrointestinal disorders that occur among dialysis patients, with an emphasis on prevalence, pathogenesis and diagnostic strategies.