Gastroduodenal findings in pediatric late-stage chronic renal failure

Abstract

Aim: In this study, we aimed to determine the characteristics of upper gastrointestinal lesions in children with end-stage chronic renal failure. Materials and Methods: Late-stage chronic renal failure (CRF) cases and healthy children who underwent endoscopy at two centers from July 2015 to September 2017 were included in this study. Patient data were collected retrospectively from medical records. Clinical characteristics, endoscopic findings, rapid urease test, Helicobacter pylori (Hp) presence, and histology were noted and compared. Hp infection is accepted as "present" if both rapid urease test and histopathology were positive. Type of gastritis (chronic active gastritis (CAG), chronic inactive gastritis (CIG), or chronic lymphocytic gastritis (CLG)) was determined by histology. Results: The CRF group (n: 43, mean age: 11.12±3.63 years, 55,8% girls) and the control group (n:492, mean age: 11.69±3.84 years, 54,1% girls) were age-and gender-matched. Abdominal pain was the most common complaint in both groups. In the CRF group, 30.2% of patients were asymptomatic. Gastropathy and ulcer at bulbus were more common in the CRF group (P<0.05). Hp infection frequency was similar between the groups (37.2% vs 33.3%, P >0,05). CAG was more common than other subtypes significantly in the CRF group than that of controls (62.8% and %44.1, respectively, P<0,05). In asymptomatic CRF patients (n:12), erosive gastritis, CAG, bulbar erosions, and Hp infection were present. Discussion: Peptic disease and CAG were frequent in the pediatric CRF patients than that of the controls. However, there was no difference in terms of Hp infection frequency. Moreover, GI pathologies were common in asymptomatic CRF patients.