Factors Affecting Gastrointestinal Disorders in Patients Undergoing Regular Hemodialysis

Authors

  • Rosarina Pasaribu Universita Sumatera Utara
  • Riri Andri Muzasti

DOI:

https://doi.org/10.32734/sumej.v3i2.3000

Keywords:

Factors affecting gastrointestinal disorders, hemodialysis

Abstract

Background: Chronic Kidney Disease (CKD) is an immense health issue. The prevalence is increasing each year worldwide, including Indonesia. Consistent with this trend, the prevalence of hemodialysis (HD) as a therapy is also increasing. CKD as well as HD often result in some complications, one being gastrointestinal disorders. Many factors are  correlated  with the incidence of gastrointestinal disorders in CKD patients undergoing HD. Objective: This research is held to observe the factors affecting gastrointestinal disorders in regular HD patients. Method: This is an observational analytical research with cross-sectional study at RS Khusus Ginjal Rasyida Medan. The datas used in the research are primary datas, obtained from Gastrointestinal Symptoms Rating Scale (GSRS) questionnaire to assess severity of gastrointestnal disorders in HD patients, and secondary datas, obtained from medical records of age, smoking history, use of aspirin, HD duration, BUN, and Kt/V (as a parameter of HD adequacy). Then the datas are analyzed univariately, bivariately, and mutivariately using biner logistic regression model. It is considered significant if the obtained p value is <0,05 (p<0,05). Result: All patients (100%) suffer from gastrointestinal disorders, with the most common being mild ones (67,1%). Final multivariate analysis shows that the duration of HD, BUN level, and Kt/V are significantly  correlated  with worsening gastrointestinal disorders (OR:14,157 ,95%CI 2,851 ± 71,183, p=0,001; OR: 8,352, 95%CI 0,914 ± 76,344, p= 0,060; OR:8,219 ,95%CI 0,893 ± 75,674, p= 0,063). Conclusion: The duration of HD, BUN level, and Kt/V are  correlated  with worsening gastrointestinal disorders in HD patients.

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References

[1] Global Burden Disease 2017, ‘Findings from the Global Burden of Disease Study 2017’, pp. 1-27. accessed 27 Maret 2019, Available at: http://www.healthdata.org/sites/default/files/files/policy_report/2019/GBD_2017_Booklet.pdf
[2] Kemenkes 2018, ‘Hasil Utama Riskesda 2018’, pp. 1-200. accessed 27 Maret 2019, Available at: http://www.depkes.go.id/
[3] Thomas, R., Panackal, C., John, M., Joshi, H., Mathai, S., Kattickaran, J., & Iqbal, M. 2013. ‘Gastrointestinal Complications in Patients with Chronic Kidney Disease—A 5-Year Retrospective Study from a Tertiary Referral Center’, Renal Failure, 35(1), pp. 49–55. doi: 10.3109/0886022X.2012.731998.
[4] Dong, R., et al. 2014. ‘Gastrointestinal symptoms: A comparison between patients undergoing peritoneal dialysis and hemodialysis’, World Journal of Gastroenterology, 20(32), 11370. doi: 10.3748/wjg.v20.i32.11370.
[5] Carrera-Jiménez, D., Miranda-Alatriste, P., Atilano-Carsi, X., Correa-Rotter, R., & Espinosa-Cuevas, Á. 2018. ‘Relationship between Nutritional Status and Gastrointestinal Symptoms in Geriatric Patients with End-Stage Renal Disease on Dialysis’, Nutrients 10(4) , 425. doi: 10.3390/nu10040425.
[6] Aoun, M., Koubar, S.H., Antoun, L., Tamim, H., Makki, M., & Chelala, D. 2017. ‘Reduction of intracerebral hemorrhage in hemodialysis patients after reducing aspirin use: A quality-assurance observational study’, PLOS ONE , 12(10), e0185847. doi: 10.1371/journal.pone.0185847.
[7] Trivedi, H., Yang, J., & Szabo, A. 2014. ‘Gastrointestinal bleeding in patients on long-term dialysis’, Journal of Nephrology, 28(2), pp. 235–243. doi: 10.1007/s40620-014-0132-6
[8] Hydarinia-Naieni, Z., Nobahar, M., & Ghorbani, R. 2017. ‘Study of Nutritional Status and Gastrointestinal Health in Patients Undergoing Hemodialysis and their Association with Laboratory Parameters and Dialysis Adequacy in Semnan, Iran’, Middle East Journal of Rehabilitation and Health Studies, 4(3), e12686 doi: 10.5812/mejrh.12686
[9] Tomizawa, M., et al. 2015. ‘Patient characteristics with high or low blood urea nitrogen in upper gastrointestinal bleeding’, World Journal of Gastroenterology, 21(24), 7500. doi: 10.3748/wjg.v21.i24.7500.
[10] Afifah., & Wardani, IY. 2018, ‘Stres Akademik dan Gejala Gastrointestinal pada Mahasiswa Keperawatan’, Jurnal Keperawatan, 6(2), pp. 121-127 accessed 30 April 2019, Available at: https://jurnal.unimus.ac.id/index.php/JKJ/article/download/4448/4078
[11] PERNEFRI 2017, ‘10th Report Of Indonesian Renal Registry’, Program Indonesia Renal Registry, pp. 1–40. accessed 27 Maret 2019, Available at: https://www.indonesianrenalregistry.org/
[12] Shabka, O., Al Ghazaly, G., Selim, M., & Zaghloul, K. 2017. ‘Upper gastrointestinal endoscopic findings in chronic kidney disease’, Tanta Medical Journal, 45(2), pp. 64-67. doi: 10.4103/tmj.tmj_7_17.
[13] Kim, M., Kim, C.S., Bae, E.H., Ma, S.K., Kim, S.W., 2019. ‘Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis’, Kidney Res Clin Pract, 38, pp. 81–89. doi: 10.23876/j.krcp.18.0060
[14] Daniels G, Robinson JR, Walker C, Pennings JS, Anderson ST. 2015. ‘Gastrointestinal Symptoms among African Americans Undergoing Hemodialysis’, Nephrol Nurs J, 42(6) , 539 -48
[15] Zuvela, J., Trimingham, C., Le Leu, R., Faull, R., Clayton, P., Jesudason, S., & Meade, A. 2018. ‘Gastrointestinal symptoms in patients receiving dialysis: A systematic review: Gastrointestinal Symptoms in Patients Receiving Dialysis’, Nephrology, 23(8), pp. 718–727. doi: 10.1111/nep.13243.
[16] Santoso, B.R., E,Y,M,A., & Asbullah. 2016, Hubungan Lama Hemodialisis dengan Penurunan Nafsu Makan pada Pasien Gagal Ginjal Kronik di Unit Hemodialisa RSUD Ulin Banjarmasin’, Dinamika kesehatan, 7(1).
[17] Cahyaningsih, D Niken. 2011. Panduan Praktis. Perawatan Gagal Ginjal. Mitra Yogyakarta: Cendekia Press.
[18] Lettino, M. 2010. ‘Inhibition of the antithrombotic effects of clopidogrel by proton pump inhibitors: Facts or fancies?’, European Journal of Internal Medicine, 21(6), pp. 484–489. doi: 10.1016/j.ejim.2010.08.004
[19] Tamura, A., Murakami, K., & Kadota, J. 2010. ‘Prevalence and independent factors for gastroduodenal ulcers/erosions in asymptomatic patients taking low-dose aspirin and gastroprotective agents: the OITA-GF study’, QJM, 104(2), pp. 133–139. doi: 10.1093/qjmed/hcq169
[20] Cryer, B., & Mahaffey, K. 2014. ‘Gastrointestinal ulcers, role of aspirin, and clinical outcomes: pathobiology, diagnosis, and treatment’, Journal of Multidisciplinary Healthcare, 137. doi: 10.2147/jmdh.s54324
[21] Li, L.F., Chan, R.L.Y., Lu, L., Shen, J., Zhang, L., Wu, W.K.K., Wang, L., Hu, T., Li, M.X., & Cho, C.H. 2014. ‘Cigarette smoking and gastrointestinal diseases: The causal relationship and underlying molecular mechanisms (Review)’, International Journal of Molecular Medicine, 34(2), pp. 372–380. doi: 10.3892/ijmm.2014.1786.
[22] Fiderkiewicz, B. 2011. ‘Factors associated with irritable bowel syndrome symptoms in hemodialysis patients’, World Journal of Gastroenterology, 17(15), pp. 1976-81. doi: 10.3748/wjg.v17.i15.1976
[23] Bargman JM, & Skorecki K. 2015. ‘Chronic Kidney Disease’ dalam Harrison’s Principles of Internal Medicine, edisi ke 19, Eds. D Kasper, A Fauci, S Hauser et.al., The McGrawHill Companies, Inc, USA.
[24] Gok, E.G., Inci, A., Coban, M., Aslan Kutsal, D., Kursat, S., 2017. ‘Functional bowel disorders and associated risk factors in hemodialysis patients in Turkey’, Turk J Gastroenterol, 28, pp. 12–19. doi: 10.5152/tjg.2016.0415
[25] Trimingham, C., McDonald, S., Dansie, K., Jesudason, S., Faull, R., Clayton, P., Liew, G., Le Leu, R., & Meade, A. 2018. ‘Bowel health in chronic kidney disease: Patient perceptions differ from clinical definitions’, Journal of Renal Care, 44(2), pp. 65–72. doi: 10.1111/jorc.12230.

Published

2019-04-20

How to Cite

1.
Pasaribu R, Muzasti RA. Factors Affecting Gastrointestinal Disorders in Patients Undergoing Regular Hemodialysis. Sumat. Med. J. [Internet]. 2019Apr.20 [cited 2024May3];3(2). Available from: https://talenta.usu.ac.id/smj/article/view/3000