Gastrointestinal and pancreatic function in peritoneal dialysis patients: their relationship with malnutrition and peritoneal membrane abnormalities

Background: Gastrointestinal (GI) disorders in peritoneal dialysis (PD) patients are relatively understudied in the literature, even though they have a serious impact in the morbidity parameters and the quality of life for this group of patients. Various diagnostic tools have been used, including instrumental methods and questionnaires, invariably validated in comparative studies. Summary: The prevalence of GI disorders is very high in PD patients. Compared to the haemodialysis patients they present a higher prevalence of reflux, eating dysfunction, gastroesophageal reflux, intestinal obstruction or adhesions and abdominal hernia. They may be divided into Gastric disorders (Gastroesophageal reflux disease, pathological Gastric emptying, Dyspepsia, Helicobacter pylori infection, peptic ulcers) and Intestinal disorders (Peritonitis, Diverticulosis, Constipation). Key Messages: The current paper is a review of the literature involving GI disorders in PD patients. This special group of patients with a special role of the peritoneal cavity and the GI motility in the physiology of their dialysis merit a larger number of studies dealing with the interrelation of the GI tract and the PD physiological, functional and pathophysiological parameters.

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“…On the contrary, other studies discovered that GI abnormalities were negatively associated with nutrition parameters in PD patients [42].…”

Section: Electrolytic Disorders and Nutritional Statusmentioning

confidence: 90%

Gastrointestinal Disorders in Peritoneal Dialysis Patients

et al. 2018

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“…Gastric motility in patients undergoing PD is lower than that in patients undergoing HD [17], and delayed gastric emptying plays an important role in the pathogenesis of peptic ulcer [18,19]. In addition, PD patients are reported have higher serum levels of gastrin [20], which stimulates gastric acid secretion and is associated with peptic ulcer.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Peptic Ulcer Disease Risk between Peritoneal and Hemodialysis Patients

Chen¹,

Wu²,

Lin³

et al. 2010

Am J Nephrol

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Background: Compared to the general population, patients with end-stage renal disease (ESRD) have increased peptic ulcer and upper GI bleeding complication rates. However, the risk factors for peptic ulcer among ESRD patients are unknown. Methods: In this retrospective study, we enrolled 827 incident dialysis patients and diagnosed peptic ulcer on the basis of endoscopic findings; information on the morbidities and medical prescription were obtained directly from medical records. A Cox regression hazard model was used to identify risk factors for peptic ulcer. Results: During the 10-year study period, 481 patients underwent an endoscopic exam. Peptic ulcers were detected in 153 patients. Age (p = 0.025), peritoneal dialysis (p = 0.022), diabetes mellitus (p = 0.020), congestive heart failure (p = 0.015), low serum albumin (p = 0.008) and high gamma-glutamyl transpeptidase (γ-GT) levels (p = 0.002) are risk factors for peptic ulcers among ESRD patients. Ulcer severity (p = 0.004) and aspirin prescription (p = 0.043), but not Helicobacter pylori infection, influenced the ulcer recurrence rate. Conclusion: The risk factors for peptic ulcer have some differences between ESRD patients and general population. In patients with high risk of upper GI bleeding, peritoneal dialysis and aspirin should be prescribed with caution.

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“…Malnutrition during critical periods of animal development may have long-term programming effects on later growth and health, as being supported by evidence from epidemiological studies, clinical intervention trials and numerous animal models (Aguilera et al, 2003;Fukuda et al, 2002;Petry et al, 2001). …”

Section: Explore Importance Of the Problemmentioning

confidence: 94%

Effects of Protein and/or Energy Restriction for Six Weeks, Followed with Nutritional Recovery on the Antioxidant Capacity and Development of Liver, Spleen and Muscle of Weaned Kids

Yang¹,

Sun²,

He³

et al. 2012

JAS

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The effects of protein and/or energy restrictions on the antioxidant capacity and development of liver, spleen and muscle were investigated in kids. Sixty Liuyang Black kids, weaned at 28-day old, were allocated to four treatments: control, either energy or protein restriction, and combined energy and protein restriction. The experimental period consisted of six weeks of nutritional restriction followed with nine weeks of nutritional recovery. On day 42, energy restriction decreased the activity of glutathione peroxidase (GSH-Px) in spleen, the superoxide dismutase (SOD) mRNA level in muscle and spleen, and the ratio of RNA to DNA in liver (P < 0.05); protein restriction decreased the activity of glutathione reductase (GR) in muscle and liver, the ratio of RNA to DNA in liver, and the N concentration and the ratio of N to DNA in spleen and muscle (P < 0.05); combined restriction of energy and protein decreased the activities of catalase and GR and the ratio of RNA to DNA in muscle, and the activities of SOD, GSH-Px and GR in spleen (P < 0.05). On day 105, there was no difference in the antioxidant parameters among four groups (P > 0.05); however, the weights of liver and spleen in groups of pre-protein restriction and pre-combined restriction of energy and protein were still less than those of kids in control. The results indicate that six weeks of nutritional restriction can reduce the antioxidant capacity of muscle, spleen and liver, retard the development of liver and spleen, and the retarded development partly continues even after nine weeks of nutritional recovery.

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Gastrointestinal and pancreatic function in peritoneal dialysis patients: their relationship with malnutrition and peritoneal membrane abnormalities

Cited by 45 publications

References 41 publications

Gastrointestinal Disorders in Peritoneal Dialysis Patients

Gastrointestinal Disorders in Peritoneal Dialysis Patients

Comparison of Peptic Ulcer Disease Risk between Peritoneal and Hemodialysis Patients

Effects of Protein and/or Energy Restriction for Six Weeks, Followed with Nutritional Recovery on the Antioxidant Capacity and Development of Liver, Spleen and Muscle of Weaned Kids

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