Factors leading to dyspepsia in renal transplant recipients

Abstract

IntroductionRenal transplantation is the definitive treatment for end stage renal disease. Patients subjected to transplantation require lifelong immunosuppression and are prone to several gastrointestinal disorders. Dyspepsia is a common disorder in these patients. The objective of this study was to determine factors leading to dyspepsia in renal (kidney) transplant recipients.MethodsIt was a cross sectional study conducted at department of hepatogastroenterology and transplant sciences, SIUT Karachi, from 1-6-15 to 1-12-15 for six months. All renal transplanted patients having dyspeptic symptoms for more than 6 weeks. EGD was performed, biopsy specimens obtained from antrum and duodenum, these were sent for histopathological examination. Frequency and percentages were obtained for categorical variables, mean ± SD was calculated for continuous variables. Chi square test was used for categorical variable and student t-test for continuous variables.ResultsNinety patients were included in the study out of which 64 (71.1%) were males, mean age was 35.82 ± 10.04 years (range: 18-65 years). Gastritis (non H.pylori associated) in 78 (78.6%), duodenitis in 35 (38.9%) and H. pylori infection in 29 (32.2%), renal transplant recipients. Most of the patients belonged to Sindhi ethnicity, 27 (30%), followed by Punjabi. Hypertension was the most common co-morbid condition in our patients found in 29 (32.2%), while most of them don't have any co morbid condition. Duodenitis was found to be associated with tacrolimus use (p = 0.037).ConclusionGastritis is the most common factor accountable for this symptoms, followed by duodenitis and H. Pylori. Patients taking tacrolimus as immunosuppressant are more prone to develop duodenitis.

Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: a review of literature

“…In recent study, 78.6% of patients had non-HP-related gastritis, 38.9% had duodenitis and 32.2% had HP infection. Duodenitis was associated with tacrolimus use [ 51 ]. Interestingly, a lower HP gastritis rate of 9.2 to 29% has been reported in gastric biopsies of kidney transplant patients [ 16 , 48 , 52 ].…”

Helicobacter pylori and nonmalignant upper gastrointestinal diseases

“…19 Among 90 renal transplanted patients with dyspeptic symptoms, non-H. pylori-associated gastritis was found in 78 (86.6%), duodenitis in 35 (38.9%), and H. pylori infection in 29 (32.2%). 20 Hence, in this context, the relevance of the bacterium seems of minor impact on dyspepsia.…”

Gastrointestinal symptoms in HIV-positive kidney transplant candidates and recipients from an HIV-positive donor

“…It was the most severe at baseline and at 6 month follow-up, possibly due to underlying gastropathology. Dyspeptic transplant recipients have shown a high prevalence of erosive changes on endoscopy, mainly gastritis (78.6%), that could be present pre-transplant 50 and/or is aggravated by immunosuppressants 8 . Tacrolimus, which has been linked to duodenitis 50 , forms part of the anti-rejection regimen in addition to mycophenolate mofetil (MMF), and prednisone 51 , and could be a contributing factor.…”