A STUDY OF UPPER GASTRO INTESTINAL ENDOSCOPIC EVALUATION IN CHRONIC RENAL FAILURE PATIENTS

Dr. A. Ravi, MD and *Dr. Jawahar Subbiah, MD

ABSTRACT

Introduction: Patients with chronic kidney disease (CKD) present with various clinical gastrointestinal (GI) symptoms and abnormalities in the GI tract. Studies on CKD patients are very few and there is not much Indian study to evaluate the frequency of these symptoms. This study was planned to our aim of this study is to evaluate the incidence of upper GI tract involvement in chronic renal failure patients. Also to find out any GI symptomatology in chronic renal failure patients with the upper gastro intestinal mucosal changes. Material and methods: The present study included 35 patients. In all patients a detailed history of the illness was taken with special reference to the gastro intestinal symptoms and subjected to a complete clinical examination. Blood urea, serum creatinine, creatinine clearance were measured and abdominal ultra-sonogram was performed. The patients were subjected to oesophago-gastro duodenoscopy. Endoscopic findings in oesophagus, stomach and duodenum were recorded. Results: In this prospective study, 26 were males and 9 were females. The age of the patients varied from 20 years to 70 years. The duration of illness varied from 3 months to 6 years. Their blood urea levels varied from 73% mgs to 196% mg. Serum creatinine ranged from 3.4 to 15.4 mgs. Their creatinine clearance from 2.8 ml to 29 ml. Nausea, vomiting, and anorexia were the most common symptoms; and erosive gastritis wes the most common endoscopic findings in CKD patients. Conclusion: Patients of chronic kidney disease frequently develop different GI symptoms and GI lesions. Persistence of endoscopic abnormality suggests that the improvement was not complete due to continued presence of uraemic toxins in non-dialysed patients. Early detection will be helpful in treating and improving the health status of the patients by reducing morbidity and mortality.

Keywords: Chronic kidney disease, haemodialysis, GI symptoms, GI endoscopy.