Comparison of Gastrointestinal Symptoms between Patients Undergoing Hemodialysis and Healthy Population

Patients with end-stage renal disease complain of many gastrointestinal (GI) problems. The goal of the current study was to compare the prevalence of GI disorders in a relatively large group of patients with end-stage renal disease (ESRD) with healthy participants.  

In a matched case-control study, 597 patients undergoing hemodialysis and 740 healthy participants were investigated. All subjects were asked to complete Rome III questionnaire, including five modules to evaluate GI disorders. The Hospital Anxiety and Depression questionnaire, as well as the 12-general health questionnaire for psychological disorders assessment, were used.

Our results showed that in patients undergoing hemodialysis, the prevalence of irritable bowel syndrome (IBS) (OR= 1.75), gastroesophageal reflux disease (GERD) (OR= 1.55), and dyspepsia (OR= 3.39) was significantly higher than in healthy control participants, while no significant difference was found in terms of constipation (OR= 0.88). The association remained significant for dyspepsia and IBS even after controlling for psychological disorders as important potential confounding variables. On the other hand, adjustment for psychological disorders led to an insignificant association between hemodialysis and GERD. Surprisingly a significant relationship was observed between constipation and hemodialysis after adjustment for mentioned psychological factors. 

Our results showed that there was a significant relationship between hemodialysis and some GI complaints such as IBS, dyspepsia, GERD, and bloating. Psychological disorders only influence GERD prevalence in patients undergoing hemodialysis.