Patient-reported gastrointestinal symptoms in patients with peritoneal dialysis: the prevalence, influence factors and association with quality of life

Chunyan Yi, Xin Wang, Hongjian Ye, Jianxiong Lin, Xiao Yang, Chunyan Yi, Xin Wang, Hongjian Ye, Jianxiong Lin, Xiao Yang

Abstract

Background: The aims of this study were to investigate the prevalence and the influence factors of gastrointestinal symptoms, and its association with the quality of life (QOL) in peritoneal dialysis (PD) patients.

Methods: Continuous ambulatory PD patients (CAPD) who followed up in our PD center between March 2016 and December 2017 were enrolled in this cross-sectional study. Gastrointestinal symptom rating scale (GSRS) was used to evaluate gastrointestinal symptoms. The related clinical data were also collected. Multiple linear regression analysis was test for the influence factors associated with score of GSRS and QOL.

Results: This study included 471 CAPD patients. The mean age was 48.5±13.9 years, 53.9% were male and 15.1% with diabetic nephropathy. The median duration of PD was 37.3 (17.5~66.5) months. The median score of GSRS was 1.2(1.1~1.3) scores. Totally 82.2% (n=387) CAPD patients had at least one gastrointestinal symptom. Higher glycosylated hemoglobin, higher score of depression, lower diastolic blood pressure, urine output, score of instrumental activities of daily living scale and more amount of pills per day were independently associated with higher score of GSRS (all P<0.05). Score of dyspepsia and eating dysfunction were independently associated with worse score of QOL and physical health (all P<0.05).

Conclusions: Gastrointestinal symptoms were common but not serious in CAPD patients. Glycemic control, depression, blood pressure, urine output, activity of daily life and amount of pills were all associated with gastrointestinal symptoms. Moreover, gastrointestinal symptoms were correlated with QOL of PD patients.

Keywords: Gastrointestinal symptoms; Peritoneal dialysis; Quality of life.

Conflict of interest statement

All authors of this study declared that there was no conflict of interest in the publication of this article.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart
Fig. 2
Fig. 2
Prevalence and severity of gastrointestinal symptoms reported by peritoneal dialysis patients

References

    1. Kosmadakis G, Albaret J, Da Costa CE, Somda F, Aguilera D. Constipation in Peritoneal Dialysis Patients. Peritoneal Dialysis Int. 2019;39(5):399–404. doi: 10.3747/pdi.2018.00169.
    1. Salamon K, Woods J, Paul E, Huggins C. Peritoneal dialysis patients have higher prevalence of gastrointestinal symptoms than hemodialysis patients. J Renal Nutr. 2013;23(2):114–118. doi: 10.1053/j.jrn.2012.02.007.
    1. Kosmadakis G, Albaret J, da Costa CE, Somda F, Aguilera D. Gastrointestinal Disorders in Peritoneal Dialysis Patients. Am J Nephrol. 2018;48(5):319–325. doi: 10.1159/000494145.
    1. Strid H, Simren M, Johansson AC, Svedlund J, Samuelsson O, Bjornsson ES. The prevalence of gastrointestinal symptoms in patients with chronic renal failure is increased and associated with impaired psychological general well-being. Nephrology Dialysis Transpl. 2002;17(8):1434–1439. doi: 10.1093/ndt/17.8.1434.
    1. Dong R, Guo ZY. Gastrointestinal symptoms in patients undergoing peritoneal dialysis: multivariate analysis of correlated factors. World J Gastroenterol. 2010;16(22):2812–2817. doi: 10.3748/wjg.v16.i22.2812.
    1. Zuvela J, Trimingham C, Le Leu R, Faull R, Clayton P, Jesudason S, Meade A. Gastrointestinal symptoms in patients receiving dialysis: A systematic review. Nephrology. 2018;23(8):718–727. doi: 10.1111/nep.13243.
    1. Strid H, Simren M, Stotzer PO, Abrahamsson H, Bjornsson ES. Delay in gastric emptying in patients with chronic renal failure. Scand J Gastroenterol. 2004;39(6):516–520. doi: 10.1080/00365520410004505.
    1. Schoonjans R, Van Vlem B, Vandamme W, Van Vlierberghe H, Van Heddeghem N, Van Biesen W, Mast A, Sas S, Vanholder R, Lameire N, et al. Gastric emptying of solids in cirrhotic and peritoneal dialysis patients: influence of peritoneal volume load. Eur J Gastroenterology Hepatol. 2002;14(4):395–398. doi: 10.1097/00042737-200204000-00010.
    1. Kim DJ, Kang WH, Kim HY, Lee BH, Kim B, Lee SK, Oh DJ, Huh W, Oh HY. The effect of dialysate dwell on gastric emptying time in patients on continuous ambulatory peritoneal dialysis. Peritoneal Dialysis Int. 1999;19(Suppl 2):S176–S178. doi: 10.1177/089686089901902S28.
    1. Van V, Schoonjans RS, Struijk DG, Verbanck JJ, Vanholder RC, Van B, Lefebvre RA, De V, Lameire NH. Influence of dialysate on gastric emptying time in peritoneal dialysis patients. Peritoneal Dialysis Int. 2002;22(1):32–38. doi: 10.1177/089686080202200106.
    1. Kim MJ, Kwon KH, Lee SW. Gastroesophageal reflux disease in CAPD patients. Adv Peritoneal Dialysis Conference Peritoneal Dialysis. 1998;14:98–101.
    1. Hylander BI, Dalton CB, Castell DO, Burkart J, Rossner S. Effect of intraperitoneal fluid volume changes on esophageal pressures: studies in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 1991;17(3):307–310. doi: 10.1016/S0272-6386(12)80479-3.
    1. Duncanson E, Chur-Hansen A, Jesudason S. Psychosocial consequences of gastrointestinal symptoms and dietary changes in people receiving automated peritoneal dialysis. J Renal Care. 2019;45(1):41–50. doi: 10.1111/jorc.12265.
    1. Zhang J, Huang C, Li Y, Chen J, Shen F, Yao Q, Qian J, Bao B, Yao X. Health-related quality of life in dialysis patients with constipation: a cross-sectional study. Patient Preference Adherence. 2013;7:589–594.
    1. Svedlund J, Sjodin I, Dotevall G. GSRS--a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Digestive diseases and sciences. 1988;33(2):129–134. doi: 10.1007/BF01535722.
    1. Svedlund J, Sullivan M, Liedman B, Lundell L. Long term consequences of gastrectomy for patient’s quality of life: the impact of reconstructive techniques. Am J Gastroenterology. 1999;94(2):438–445. doi: 10.1111/j.1572-0241.1999.874_c.x.
    1. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Maryland State Med J. 1965;14:61–65.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186. doi: 10.1093/geront/9.3_Part_1.179.
    1. Wang Z, Yuan CM, Huang J, Li ZZ, Chen J, Zhang HY, Fang YR, Xiao ZP. Reliability and validity of the Chinese version of Beck Depression Inventory-II among depression patients. Chinese Mental Health J. 2011;25(6):476–479.
    1. McHorney CA, Ware JE, Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care. 1993;31(3):247–263. doi: 10.1097/00005650-199303000-00006.
    1. Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016;4:2050312116671725. doi: 10.1177/2050312116671725.
    1. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–383. doi: 10.1016/0021-9681(87)90171-8.
    1. Schvarcz E, Palmer M, Ingberg CM, Aman J, Berne C. Increased prevalence of upper gastrointestinal symptoms in long-term type 1 diabetes mellitus. Diabetic Med. 1996;13(5):478–481. doi: 10.1002/(SICI)1096-9136(199605)13:5<478::AID-DIA104>;2-5.
    1. Kim JH, Park HS, Ko SY, Hong SN, Sung IK, Shim CS, Song KH, Kim DL, Kim SK, Oh J. Diabetic factors associated with gastrointestinal symptoms in patients with type 2 diabetes. World J Gastroenterol. 2010;16(14):1782–1787. doi: 10.3748/wjg.v16.i14.1782.
    1. Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Int Med. 2001;161(16):1989–1996. doi: 10.1001/archinte.161.16.1989.
    1. Bytzer P, Talley NJ, Hammer J, Young LJ, Jones MP, Horowitz M. GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications. Am J Gastroenterol. 2002;97(3):604–611. doi: 10.1111/j.1572-0241.2002.05537.x.
    1. Chong VH, Tan J. Prevalence of gastrointestinal and psychosomatic symptoms among Asian patients undergoing regular hemodialysis. Nephrology. 2013;18(2):97–103. doi: 10.1111/nep.12000.
    1. Kahvecioglu S, Akdag I, Kiyici M, Gullulu M, Yavuz M, Ersoy A, Dilek K, Yurtkuran M. High prevalence of irritable bowel syndrome and upper gastrointestinal symptoms in patients with chronic renal failure. J Nephrol. 2005;18(1):61–66.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa