Keywords
Gastrointestinal diseases
gastrointestinal tract
chronic renal failure
digestive signs and symptoms
symptom assessment
uremia.
gastrointestinal tract
chronic renal failure
digestive signs and symptoms
symptom assessment
uremia.
How to Cite
1.
Santacoloma Osorio M, Camilo Giraldo G. Gastrointestinal manifestations of chronic kidney disease. Rev. Colomb. Nefrol. [Internet]. 2017 Feb. 7 [cited 2024 Apr. 19];4(1):17-26. Available from: https://revistanefrologia.org/index.php/rcn/article/view/266
Abstract
Introduction: There is a wide variety of gastrointestinal clinical manifestations that may increase the deterioration of the quality of life in patients with chronic kidney disease (CKD), which are manageable if properly detected.
Objective: The objective of this work is to perform an updated and analytical re-view of the literature on the manifestations in the digestive tract of patients with chronic deterioration of renal function.
Results: The results indicate that some of the signs and symptoms on the gastrointestinal tract of patients with CKD are individual, and non-specific symptoms such as anorexia, nausea and vomiting predominate, which can be controlled with adequate renal replacement therapy; while thers, more rare, such as ascites associated with dialysis, impoverish the prognosis and illustrate the need for transplantation.
References
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2. Hammer J, Oesterreicher C, Hammer K, Koch U, Traindl O, Kovarik J. Chronic gastrointestinal symptoms in hemodialysis patients. Wien Klin Wochenschr. 1998 Apr;110(8):287-91.
3. Grant CJ, Harrison LE, Hoad CL, Marciani L, Gowland PA, McIntyre CW. Patients with CKD have abnormal upper gastro-intestinal tract digestive function: a study of uremic enteropathy. J Gastroenterol Hepatol. 2016 May 25.
4. Etemad B. Gastrointestinal complications of renal failure. Gastroenterol Clin North Am. 1998;27(4):875-92.
5. Almutary H, Douglas C, Bonner A. Multidimensional symptom clusters: an exploratory factor analysis in advanced chronic kidney disease. J Adv Nurs. 2016 Oct;72(10):2389-400.
6. Chong VH, Tan J. Prevalence of gastrointestinal and psychosomatic symptoms among Asian patients undergoing regular hemodialysis. Nephrology (Carlton). 2013 Feb;18(2):97-103.
7. Hirako M, Kamiya T, Misu N, Kobayashi Y, Adachi H, Shikano, M, et al. Impaired gastric motility and its relationship to gastrointestinal symptoms in patients with chronic renal failure. J Gastroenterol. 2005 Dec;40(12):1116-122.
8. Vaziri ND, Zhao YY, Pahl MV. Altered intestinal microbial flora and impaired epithelial barrier structure and function in CKD: the nature, mechanisms, consequences and potential treatment. Nephrol Dial Transplant. 2016 May;31(5):737-46.
9. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001 Feb;32(3):331-51.
10. Bargman JM. Hernias in peritoneal dialysis patients: limiting occurrence and recurrence. Perit Dial Int. 2008 Jul-Aug;28(4):349-351.
11. Lee YC, Hung SY, Wang HH, Wang HK, Lin CW, Chang MY, et al. Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemodialysis or Peritoneal Dialysis or With Non- End Stage Renal Disease: A Nationwide Population-Based Cohort Study. Somchai A, ed. Medicine. 2015 Sep;94(36):e1482.
12. Laperrousaz S, Drepper VJ. Overview of peritoneal dialysis. Rev Med Suisse. 2016 Feb;24;12(507):408-12.
13. Martola L, Wuorela M. When and for whom to start dialytic therapy?. Duodecim. 2015;131(19):1757-62.
14. Manley KJ. Will mouth wash solutions of water, salt, sodium bicarbonate or citric acid improve upper gastrointestinal symptoms in chronic kidney disease. Nephrology (Carlton). 2016 Feb.
15. Oyetola EO, Owotade FJ, Agbelusi GA, Fatusi OA, Sanusi AA. Oral findings in chronic kidney disease: implications for management in developing countries. BMC Oral Health. 2015 Feb;15(1):24.
16. Leão JC, Gueiros LA, Segundo AV, Carvalho AA, Barrett W, Porter SR. Uremic stomatitis in chronic renal failure. Clinics. 2005 Jun;60(3):259-62.
17. Iwakiri K, Kinoshita Y, Habu Y, Oshima T, Manabe N, Fujiwara Y, et al. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015. J Gastroenterol. 2016 Aug;51(8):751-67.
18. Yeh CN, Chen MF, Jan YY. Laparoscopic cholecystectomy for 58 end stage renal disease patients. Surg Endosc. 2005 Jul;19(7):915-8.
19. Li Vecchi M, Cesare S, Soresi M, Arnone S, Renda F, Di Natale E, et al. Prevalence of biliary lithiasis in a Sicilian population of hemodialysis patients. Clin Nephrol. 2001 Feb;55(2):127-32.
20. Sheu BS, Huang JJ. Helicobacter pylori infection in hemodialysis patients. Int J Artif Organs. 2001 Oct;24(10):669-70.
21. Nakajima F, Sakaguchi M, Amemoto K, Oka H, Kubo M, Shibahara N, et al. Helicobacter pylori in patients receiving long-term dialysis. Am J Nephrol. 2002 sep-Dec;22(5-6):468-72.
22. Fabrizi F, Martin P. Helicobacter pylori infection in patients with end stage renal disease. Int J Artif Organs. 2000 Mar; 23(3):157-64.
23. Huang JJ, Huang CJ, Ruaan MK, Chen KW, Yen TS, Sheu BS, et al. Diagnostic efficacy of (13) C-urea breath test for Helicobacter pylori infection in hemodialysis patients. Am J Kidney Dis. 2000 Jul;36(1):124-9.
24. Liang CC, Muo CH, Wang IK, Chang CT, Chou CY, Liu JH, et al. Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications. PLoS One. 2014 Feb;9(2):e87952.
25. Usman R, Faiq SM. Angiodysplasia in patient with chronic kidney disease. J Coll Physicians Surg Pak. 2013 Feb;23(2):170.
26. Grooteman KV1, van Geenen EJ, Drenth JP. High variation in treatment strategies for gastrointestinal angiodysplasias. Eur J Gastroenterol Hepatol. 2016 Sep;28(9):1082-6.
27. Murtagh FE, Addington-Hall J, Edmonds P, Donohoe P, Carey I, Jenkins K, et al. Symptoms in the month before death for stage 5 chronic kidney disease patients managed without dialysis. J Pain Symptom Manage. 2010 Sep;40(3):342-52.
28. Scheff RT, Zuckerman G, Harter H, Delmez J, Koehler R. Diverticular disease in patients with chronic renal failure due to polycystic kidney disease. Ann Intern Med. 1980 Feb;92(2):202-4.
29. Galbraith P, Bagg MN, Schabel SI, Rajagopalan PR. Diverticular complications of renal failure. Gastrointest Radiol. 1990 summer;15(3):259-62.
30. Chang SS1, Huang N, Hu HY. Patients with end-stage renal disease were at an increased risk of hospitalization for acute diverticulitis. Medicine (Baltimore). 2016 Sep;95(39): 4881.
31. Brown KM. Isolated ascending colon ulceration in a patient with chronic renal insufficiency. J Natl Med Assoc. 1992 Feb;84(2):185-7.
32. Milito G, Taccone-Gallucci M, Brancaleone C, Nardi F, Cesca D, Boffo V, et al. The gastrointestinal tract in uremic patients on long-term hemodialysis. Kidney Int Suppl. 1985 Dec;17:S157-60.
33. Capitanini A, Bozzoli L, Rollo S, Pirolo B, Giannese D, Zullo C, et al. The presence of crystals of sodium polystyrene sulfonate in the colonic wall: innocent bystander or pathogenic factor? G Ital Nefrol. 2016 Mar-Apr;33(2).
34. Parnaby CN, Barrow EJ, Edirimanne SB, Parrott NR, Frizelle FA, Watson AJ. Colorectal complications of end-stage renal failure and renal transplantation: a review. Colorectal Dis. 2012 Apr;14(4):403-15.
35. Bassilios N, Menoyo V, Berger A, Mamzer M-F, Daniel F, Cluzel P, et al. Mesenteric ischaemia in haemodialysis patients: a case/control study. ephrol Dial Transplant 2003 May; 18(5):911-7.
36. Ori Y, Chagnac A, Schwartz A, et al. Non-occlusive mesenteric ischemia in chronically dialyzed patients: a disease with multiple risk factors. Nephron Clin Pract. 2005;101(2):c87-93.
37. Flobert C, Cellier C, Berger A, Ngo A, Cuillerier E, Landi B, et al. Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis. Am J Gastroenterol. 2000 Jan;95(1):195-8.
38. Yang JY, Lee TC, Montez-Rath ME, et al. Trends in acute nonvariceal upper gastrointestinal bleeding in dialysis patients. J Am Soc Nephrol. 2012 Mar;23(3): 495-506.
39. Jutabha R, Jensen DM. Management of upper gastrointestinal bleeding in the patient with chronic liver disease. Med Clin North Am. 1996 Sep;80(5):1035-68.
40. Huang KW, Leu HB, Luo JC, Chan WL, Hou MC, Lin HC, et al. Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis. Dig Dis Sci. 2014 Apr;59(4):807-13.
41. Bruno MJ, van Westerloo DJ, van Dorp WT, Dekker W, Ferwerda J, Tytgat GNJ, et al. Acute pancreatitis in peritoneal dialysis and haemodialysis: risk, clinical course, outcome, and possible aetiology. Gut. 2000;46(3):385-89.
42. Lankisch PG, Weber-Dany B, Maisonneuve P, Lowenfels AB. Frequency and severity of acute pancreatitis in chronic dialysis patients. Nephrol Dial Transplant. 2008 Apr;23(4):1401-5.
43. Gunal AI, Karaca I, Celiker H, Ilkay E, Duman S, et al. Strict volume control in the treatment of nephrogenic ascites. Nephrol Dial Transplant 2002 Jul;17(7):1248-51.
44. Melero M, Rodriguez M, Araque A, Alamo C, Andrés A, Praga M. Idiopathic dialysis ascites in the nineties: resolution after renal transplantation. Am J Kidney Dis. 1995 Oct;26(4):668-70.
45. Meola M, Samoni S, Petrucci I. Clinical Scenarios in Chronic Kidney Disease: Cystic Renal Diseases. Contrib Nephrol. 2016;188:120-30.
46. Thomas MC, Cooper ME, Zimmet P. Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease. Nat Rev Nephrol. 2016 Feb;12(2):73-81.
47. Mehrotra R, Devuyst O, Davies SJ, Johnson DW. The Current State of Peritoneal Dialysis. J Am Soc Nephrol. 2016 Nov;27(11):3238-52.
48. Sattar S, Khan N, Ahmad F, Adnan F, Danish SH. Post-dialysis effects in patients on haemodialysis. J Pak Med Assoc. 2016 Jun;66(6):781-8.
49. Ponticelli C, Passerini P. Gastrointestinal complications in renal transplant recipients. Transpl Int. 2005 Jun;18(6):643–50.
50. Davies NM, et al. Gastrointestinal side effects of mycophenolic acid in renal transplant patients: a reappraisal. Nephrol Dial Transplant. 2007 Sep;22(9):2440-8.
2. Hammer J, Oesterreicher C, Hammer K, Koch U, Traindl O, Kovarik J. Chronic gastrointestinal symptoms in hemodialysis patients. Wien Klin Wochenschr. 1998 Apr;110(8):287-91.
3. Grant CJ, Harrison LE, Hoad CL, Marciani L, Gowland PA, McIntyre CW. Patients with CKD have abnormal upper gastro-intestinal tract digestive function: a study of uremic enteropathy. J Gastroenterol Hepatol. 2016 May 25.
4. Etemad B. Gastrointestinal complications of renal failure. Gastroenterol Clin North Am. 1998;27(4):875-92.
5. Almutary H, Douglas C, Bonner A. Multidimensional symptom clusters: an exploratory factor analysis in advanced chronic kidney disease. J Adv Nurs. 2016 Oct;72(10):2389-400.
6. Chong VH, Tan J. Prevalence of gastrointestinal and psychosomatic symptoms among Asian patients undergoing regular hemodialysis. Nephrology (Carlton). 2013 Feb;18(2):97-103.
7. Hirako M, Kamiya T, Misu N, Kobayashi Y, Adachi H, Shikano, M, et al. Impaired gastric motility and its relationship to gastrointestinal symptoms in patients with chronic renal failure. J Gastroenterol. 2005 Dec;40(12):1116-122.
8. Vaziri ND, Zhao YY, Pahl MV. Altered intestinal microbial flora and impaired epithelial barrier structure and function in CKD: the nature, mechanisms, consequences and potential treatment. Nephrol Dial Transplant. 2016 May;31(5):737-46.
9. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001 Feb;32(3):331-51.
10. Bargman JM. Hernias in peritoneal dialysis patients: limiting occurrence and recurrence. Perit Dial Int. 2008 Jul-Aug;28(4):349-351.
11. Lee YC, Hung SY, Wang HH, Wang HK, Lin CW, Chang MY, et al. Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemodialysis or Peritoneal Dialysis or With Non- End Stage Renal Disease: A Nationwide Population-Based Cohort Study. Somchai A, ed. Medicine. 2015 Sep;94(36):e1482.
12. Laperrousaz S, Drepper VJ. Overview of peritoneal dialysis. Rev Med Suisse. 2016 Feb;24;12(507):408-12.
13. Martola L, Wuorela M. When and for whom to start dialytic therapy?. Duodecim. 2015;131(19):1757-62.
14. Manley KJ. Will mouth wash solutions of water, salt, sodium bicarbonate or citric acid improve upper gastrointestinal symptoms in chronic kidney disease. Nephrology (Carlton). 2016 Feb.
15. Oyetola EO, Owotade FJ, Agbelusi GA, Fatusi OA, Sanusi AA. Oral findings in chronic kidney disease: implications for management in developing countries. BMC Oral Health. 2015 Feb;15(1):24.
16. Leão JC, Gueiros LA, Segundo AV, Carvalho AA, Barrett W, Porter SR. Uremic stomatitis in chronic renal failure. Clinics. 2005 Jun;60(3):259-62.
17. Iwakiri K, Kinoshita Y, Habu Y, Oshima T, Manabe N, Fujiwara Y, et al. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015. J Gastroenterol. 2016 Aug;51(8):751-67.
18. Yeh CN, Chen MF, Jan YY. Laparoscopic cholecystectomy for 58 end stage renal disease patients. Surg Endosc. 2005 Jul;19(7):915-8.
19. Li Vecchi M, Cesare S, Soresi M, Arnone S, Renda F, Di Natale E, et al. Prevalence of biliary lithiasis in a Sicilian population of hemodialysis patients. Clin Nephrol. 2001 Feb;55(2):127-32.
20. Sheu BS, Huang JJ. Helicobacter pylori infection in hemodialysis patients. Int J Artif Organs. 2001 Oct;24(10):669-70.
21. Nakajima F, Sakaguchi M, Amemoto K, Oka H, Kubo M, Shibahara N, et al. Helicobacter pylori in patients receiving long-term dialysis. Am J Nephrol. 2002 sep-Dec;22(5-6):468-72.
22. Fabrizi F, Martin P. Helicobacter pylori infection in patients with end stage renal disease. Int J Artif Organs. 2000 Mar; 23(3):157-64.
23. Huang JJ, Huang CJ, Ruaan MK, Chen KW, Yen TS, Sheu BS, et al. Diagnostic efficacy of (13) C-urea breath test for Helicobacter pylori infection in hemodialysis patients. Am J Kidney Dis. 2000 Jul;36(1):124-9.
24. Liang CC, Muo CH, Wang IK, Chang CT, Chou CY, Liu JH, et al. Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications. PLoS One. 2014 Feb;9(2):e87952.
25. Usman R, Faiq SM. Angiodysplasia in patient with chronic kidney disease. J Coll Physicians Surg Pak. 2013 Feb;23(2):170.
26. Grooteman KV1, van Geenen EJ, Drenth JP. High variation in treatment strategies for gastrointestinal angiodysplasias. Eur J Gastroenterol Hepatol. 2016 Sep;28(9):1082-6.
27. Murtagh FE, Addington-Hall J, Edmonds P, Donohoe P, Carey I, Jenkins K, et al. Symptoms in the month before death for stage 5 chronic kidney disease patients managed without dialysis. J Pain Symptom Manage. 2010 Sep;40(3):342-52.
28. Scheff RT, Zuckerman G, Harter H, Delmez J, Koehler R. Diverticular disease in patients with chronic renal failure due to polycystic kidney disease. Ann Intern Med. 1980 Feb;92(2):202-4.
29. Galbraith P, Bagg MN, Schabel SI, Rajagopalan PR. Diverticular complications of renal failure. Gastrointest Radiol. 1990 summer;15(3):259-62.
30. Chang SS1, Huang N, Hu HY. Patients with end-stage renal disease were at an increased risk of hospitalization for acute diverticulitis. Medicine (Baltimore). 2016 Sep;95(39): 4881.
31. Brown KM. Isolated ascending colon ulceration in a patient with chronic renal insufficiency. J Natl Med Assoc. 1992 Feb;84(2):185-7.
32. Milito G, Taccone-Gallucci M, Brancaleone C, Nardi F, Cesca D, Boffo V, et al. The gastrointestinal tract in uremic patients on long-term hemodialysis. Kidney Int Suppl. 1985 Dec;17:S157-60.
33. Capitanini A, Bozzoli L, Rollo S, Pirolo B, Giannese D, Zullo C, et al. The presence of crystals of sodium polystyrene sulfonate in the colonic wall: innocent bystander or pathogenic factor? G Ital Nefrol. 2016 Mar-Apr;33(2).
34. Parnaby CN, Barrow EJ, Edirimanne SB, Parrott NR, Frizelle FA, Watson AJ. Colorectal complications of end-stage renal failure and renal transplantation: a review. Colorectal Dis. 2012 Apr;14(4):403-15.
35. Bassilios N, Menoyo V, Berger A, Mamzer M-F, Daniel F, Cluzel P, et al. Mesenteric ischaemia in haemodialysis patients: a case/control study. ephrol Dial Transplant 2003 May; 18(5):911-7.
36. Ori Y, Chagnac A, Schwartz A, et al. Non-occlusive mesenteric ischemia in chronically dialyzed patients: a disease with multiple risk factors. Nephron Clin Pract. 2005;101(2):c87-93.
37. Flobert C, Cellier C, Berger A, Ngo A, Cuillerier E, Landi B, et al. Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis. Am J Gastroenterol. 2000 Jan;95(1):195-8.
38. Yang JY, Lee TC, Montez-Rath ME, et al. Trends in acute nonvariceal upper gastrointestinal bleeding in dialysis patients. J Am Soc Nephrol. 2012 Mar;23(3): 495-506.
39. Jutabha R, Jensen DM. Management of upper gastrointestinal bleeding in the patient with chronic liver disease. Med Clin North Am. 1996 Sep;80(5):1035-68.
40. Huang KW, Leu HB, Luo JC, Chan WL, Hou MC, Lin HC, et al. Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis. Dig Dis Sci. 2014 Apr;59(4):807-13.
41. Bruno MJ, van Westerloo DJ, van Dorp WT, Dekker W, Ferwerda J, Tytgat GNJ, et al. Acute pancreatitis in peritoneal dialysis and haemodialysis: risk, clinical course, outcome, and possible aetiology. Gut. 2000;46(3):385-89.
42. Lankisch PG, Weber-Dany B, Maisonneuve P, Lowenfels AB. Frequency and severity of acute pancreatitis in chronic dialysis patients. Nephrol Dial Transplant. 2008 Apr;23(4):1401-5.
43. Gunal AI, Karaca I, Celiker H, Ilkay E, Duman S, et al. Strict volume control in the treatment of nephrogenic ascites. Nephrol Dial Transplant 2002 Jul;17(7):1248-51.
44. Melero M, Rodriguez M, Araque A, Alamo C, Andrés A, Praga M. Idiopathic dialysis ascites in the nineties: resolution after renal transplantation. Am J Kidney Dis. 1995 Oct;26(4):668-70.
45. Meola M, Samoni S, Petrucci I. Clinical Scenarios in Chronic Kidney Disease: Cystic Renal Diseases. Contrib Nephrol. 2016;188:120-30.
46. Thomas MC, Cooper ME, Zimmet P. Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease. Nat Rev Nephrol. 2016 Feb;12(2):73-81.
47. Mehrotra R, Devuyst O, Davies SJ, Johnson DW. The Current State of Peritoneal Dialysis. J Am Soc Nephrol. 2016 Nov;27(11):3238-52.
48. Sattar S, Khan N, Ahmad F, Adnan F, Danish SH. Post-dialysis effects in patients on haemodialysis. J Pak Med Assoc. 2016 Jun;66(6):781-8.
49. Ponticelli C, Passerini P. Gastrointestinal complications in renal transplant recipients. Transpl Int. 2005 Jun;18(6):643–50.
50. Davies NM, et al. Gastrointestinal side effects of mycophenolic acid in renal transplant patients: a reappraisal. Nephrol Dial Transplant. 2007 Sep;22(9):2440-8.
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