[Gastroesophageal reflux disease and its' influence on nutritional status in patients treated with peritoneal dialysis].

OBJECTIVE

The aim of our study was to estimate the correlation between GERD symptoms and nutritional status of (PD) patients.

METHODS

52 patients (32 m, 20 f; age 30-86, mean 61.6+/-14.3) treated with continuous ambulatory PD were reviewed using standarized GERD symptoms questionnaire. The frequency, duration, intensity and day/night prevalence of typical GERD sypmtoms were estimated and calculated as symptom score index (0-80). Than to evaluate the nutritional status, normalized protein catabolic rate (nPCR) was calculated. Correlation was calculated with r - Pearson's correlation coefficient. Additionally the correlation between GERD symptom score index and following parameters was evaluated: the time from the diagnosis of chronic renal failure, the time from the onset of CAPD, weekly clearance of endogenous creatinine and Kt/V value.

RESULTS

43 patients had symptoms of GERD. The symptom score index was between 4 and 50 (mean 11.3+/-10.7). Symptoms were present also in patients with ongoing H2-blockers (18 pts) and PPI therapy (2 pts). Mean value of nPCR for the study group was 0.99+/-0.26. Evident negative correlation was observed between these two values (R = -0.28; p = 0.04). Kt/V index was 2.28+/-0.57 and weekly KEK was 89.26+/-23.37. Both parameters showed only very weak correlation with GERD index (respectively: R = -0.16; p = 0.25 and R = -0.142; p = 0.31). There was no correlation between symptom score index and albumin nor transferine level. Interestingly, there was positive correlation observed between GERD symptom score and the time from onset of CAPD (R = 0.229; p = 0.10) and no correlation with the time from the first diagnosis of chronic renal failure.

CONCLUSIONS

Gastro-esophageal reflux disease symptoms adversely affect nutritional status, estimated via nPCR value in chronic renal failure patients, treated with peritoneal dialysis. Moreover, as all the patients had weekly clearance of endogenous creatinine within normal range or even above, we can conclude that the occurrence of GERD symptoms in CAPD patients is not related to the adequacy of dialysis but rather to other factors as the presence of fluid in peritoneal cavity. Even more probable is that other mechanisms (autonomic dysfunction or hormonal imbalance) contribute, as the GERD symptom score index correlates with the time past from the CAPD onset.