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Böbrek nakil adaylarında üst gastrointestinal sistem taraması gerekli mi?

Yıl 2023, Cilt: 13 Sayı: 2, 377 - 380, 22.03.2023
https://doi.org/10.16899/jcm.1262882

Öz

AMAÇ
Çalışmadaki amacımız gastrointestinal sistem hastalık insidansı yüksek olan renal nakil adayı olan hastalarda üst GIS endoskopi bulgularını sunmak ve tartışmaktır.
MATERYAL METOD
Ocak 2014-Aralık 2019 tarihleri arasında Karadeniz Teknik Üniversitesi Farabi Hastanesi’nde kronik böbrek yetmezliği nedeniyle diyalize giren, renal nakil adayı olan 18 yaş üstündeki hastalar çalışmaya dâhil edildi. Hastaların üst gastrointestinal endoskopik bulguları ve patoloji sonuçları (atrofi, helikobakter pylori ve intestinal metaplazi) retrospektif olarak hastanenin elektronik arşiv sisteminden taranarak değerlendirildi.
BULGULAR
Çalışmaya 105 hasta dâhil edildi. Hastaların 53’ü (%50,5) erkek idi. Hastaların ortalama yaşı 44,09 ± 14,16 idi, kadın ve erkek cinsiyet arasında yaş açısından istatistiksel olarak anlamlı farklılık saptanmadı (p=0,961). En sık görülen bulgular endoskopik bulgular pangastrit (%44,8), antral gastrit (%27,6) ve özofajit (%16,2) idi. Sadece 4 (%3.8) olguda duodenal ülser belirlendi. Atrofi değerlendirilmesi yapılabilen 23 hastanın 3’ünde (%13) atrofi, HP değerlendirmesi yapılan 67 hastanın 19’unda (%27,1) HP ve intestinal metaplazi (IM) değerlendirmesi yapılan 56 hastanın 17’sinde (%24,3) IM pozitif saptandı.
SONUÇ
Renal nakil adayı olan hastalar nakil sonrası gelişebilecek üst GI sistem komplikasyonlarının önlenmesi amacıyla nakil öncesi rutin üst endoskopik inceleme endikasyonu gözden geçirilmelidir.

Kaynakça

  • 1. Braunwald E, Fauci As, Kasper DL. Chronic renal failure. In: Skorecki K, Green J, Brenner BM, editors. Harrison’s Principles of Internal Medicine. 16th ed. New York; 2005.
  • 2. Shirazian S, Radhakrishnan J. Gastrointestinal disorders and renal failure: exploring the connection. Nat Rev Nephrol. 2010;6(8):480–92.
  • 3. Chong VH. Impact of duration of hemodialysis on gastrointestinal symptoms in patients with end stage renal failure. J Gastrointestin Liver Dis. 2010;19(4):462–3.
  • 4. Abu Farsakh NA, Roweily E, Rababaa M, Butchoun R. Brief report: evaluation of the upper gastrointestinal tract in uraemic patients undergoing haemodialysis. Nephrol Dial Transplant. 1996;11(5):847–50.
  • 5. Krishnan A, Venkataraman RSJ. Gastrointestinal Evaluation in Chronic Kidney Diseases. J Nephrol Ther [Internet]. 2011;01(03). Available from: https://www.omicsonline.org/gastrointestinal-evaluation-in-chronic-kidney-diseases-2161-0959.1000110.php?aid=3190
  • 6. Helderman JH, Goral S. Gastrointestinal Complications of Transplant Immunosuppression. Journal of the American Society of Nephrology. 2002;13(1):277–87.
  • 7. Abu Farsakh NA, Roweily E, Rababaa M, Butchoun R. Evaluation of the upper gastrointestinal tract in uraemic patients undergoing haemodialysis. Nephrology Dialysis Transplantation. 1996 1;11(5):847–50.
  • 8. Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol. 2017;13(2):104–14.
  • 9. Asaka M, Kato M, Takahashi Sichi, et al. Guidelines for the Management of Helicobacter pylori Infection in Japan: 2009 Revised Edition. Helicobacter. 2010;15(1):1–20.
  • 10. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut [Internet]. 2017;66(1):6–30.
  • 11. Nardone G, Rocco A, Fiorillo M, et al. Gastroduodenal Lesions and Helicobacter pylori Infection in Dyspeptic Patients With and Without Chronic Renal Failure. Helicobacter. 2005;10(1):53–8.
  • 12. Homse Netto JP, Pinheiro JPS, Ferrari ML, et al. Upper gastrointestinal alterations in kidney transplant candidates. Brazilian Journal of Nephrology. 2018 14;40(3):266–72.
  • 13. Durak S, Coşar AM. Fidan S. Determination of the Frequency of Gastric Intestinal Metaplasia and Its Association with Helicobacter Pylori. Medical Records. 2022; 4(3): 467-472.
  • 14. Correa P. Gastric Cancer. Gastroenterol Clin North Am. 2013 Jun;42(2):211–7.
  • 15. Wasse H, Gillen DL, Ball AM, et al. Risk factors for upper gastrointestinal bleeding among end-stage renal disease patients. Kidney Int. 2003;64(4):1455–61.

Is upper gastrointestinal system screening necessary in kidney transplant candidates?

Yıl 2023, Cilt: 13 Sayı: 2, 377 - 380, 22.03.2023
https://doi.org/10.16899/jcm.1262882

Öz

BACKGROUND
The aim of this study is to present and discuss upper gastrointestinal tract endoscopy findings in renal transplant candidates with a high incidence of gastrointestinal system diseases.
METHODS
Between January 2014 and December 2019, patients over the age of 18 who were on dialysis for chronic renal failure and renal transplant candidates at xxx University xxx Hospital were included in the study. Upper gastrointestinal endoscopic findings and pathology results (atrophy, helicobacter pylori and intestinal metaplasia) of the patients were retrospectively evaluated by scanning from the electronic archive system of the hospital.
RESULTS
The study included 105 patients. 53 (50.5%) of the patients were male. The mean age of the patients was 44.09 ± 14.16 years and there was no statistically significant difference between male and female sexes (p=0.961). The most common endoscopic findings were pangastritis (44.8%), antral gastritis (27.6%) and esophagitis (16.2%). Only 4 (3.8%) patients had duodenal ulcer. Atrophy was positive in 3 (13%) of 23 patients, HP was positive in 19 (27.1%) of 67 patients and IM was positive in 17 (24.3%) of 56 patients.
CONCLUSIONS
Patients who are renal transplant candidates should be reviewed for indication of routine upper endoscopic examination before transplantation to prevent upper GI tract complications that may develop after transplantation.

Kaynakça

  • 1. Braunwald E, Fauci As, Kasper DL. Chronic renal failure. In: Skorecki K, Green J, Brenner BM, editors. Harrison’s Principles of Internal Medicine. 16th ed. New York; 2005.
  • 2. Shirazian S, Radhakrishnan J. Gastrointestinal disorders and renal failure: exploring the connection. Nat Rev Nephrol. 2010;6(8):480–92.
  • 3. Chong VH. Impact of duration of hemodialysis on gastrointestinal symptoms in patients with end stage renal failure. J Gastrointestin Liver Dis. 2010;19(4):462–3.
  • 4. Abu Farsakh NA, Roweily E, Rababaa M, Butchoun R. Brief report: evaluation of the upper gastrointestinal tract in uraemic patients undergoing haemodialysis. Nephrol Dial Transplant. 1996;11(5):847–50.
  • 5. Krishnan A, Venkataraman RSJ. Gastrointestinal Evaluation in Chronic Kidney Diseases. J Nephrol Ther [Internet]. 2011;01(03). Available from: https://www.omicsonline.org/gastrointestinal-evaluation-in-chronic-kidney-diseases-2161-0959.1000110.php?aid=3190
  • 6. Helderman JH, Goral S. Gastrointestinal Complications of Transplant Immunosuppression. Journal of the American Society of Nephrology. 2002;13(1):277–87.
  • 7. Abu Farsakh NA, Roweily E, Rababaa M, Butchoun R. Evaluation of the upper gastrointestinal tract in uraemic patients undergoing haemodialysis. Nephrology Dialysis Transplantation. 1996 1;11(5):847–50.
  • 8. Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol. 2017;13(2):104–14.
  • 9. Asaka M, Kato M, Takahashi Sichi, et al. Guidelines for the Management of Helicobacter pylori Infection in Japan: 2009 Revised Edition. Helicobacter. 2010;15(1):1–20.
  • 10. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut [Internet]. 2017;66(1):6–30.
  • 11. Nardone G, Rocco A, Fiorillo M, et al. Gastroduodenal Lesions and Helicobacter pylori Infection in Dyspeptic Patients With and Without Chronic Renal Failure. Helicobacter. 2005;10(1):53–8.
  • 12. Homse Netto JP, Pinheiro JPS, Ferrari ML, et al. Upper gastrointestinal alterations in kidney transplant candidates. Brazilian Journal of Nephrology. 2018 14;40(3):266–72.
  • 13. Durak S, Coşar AM. Fidan S. Determination of the Frequency of Gastric Intestinal Metaplasia and Its Association with Helicobacter Pylori. Medical Records. 2022; 4(3): 467-472.
  • 14. Correa P. Gastric Cancer. Gastroenterol Clin North Am. 2013 Jun;42(2):211–7.
  • 15. Wasse H, Gillen DL, Ball AM, et al. Risk factors for upper gastrointestinal bleeding among end-stage renal disease patients. Kidney Int. 2003;64(4):1455–61.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Serdar DURAK
Kanuni Training and Research Hospital, Department of Gastroenterology,
0000-0002-8175-9611
Türkiye


Murat ERKUT
KARADENIZ TECHNICAL UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, GASTROENTEROLOGY
0000-0003-3613-3449
Türkiye


Sami FİDAN
KARADENIZ TECHNICAL UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, GASTROENTEROLOGY
0000-0002-7412-4319
Türkiye


Beyza ALGÜL DURAK
Ankara Bilkent City Hospital, Department of Nephrology
0000-0002-3182-4382
Türkiye


Arif Mansur COŞAR
KARADENIZ TECHNICAL UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, GASTROENTEROLOGY
0000-0002-4472-2895
Türkiye

Erken Görünüm Tarihi 23 Ocak 2023
Yayımlanma Tarihi 22 Mart 2023
Kabul Tarihi 20 Mart 2023
Yayınlandığı Sayı Yıl 2023 Cilt: 13 Sayı: 2

Kaynak Göster

AMA Durak S. , Erkut M. , Fidan S. , Algül Durak B. , Coşar A. M. Is upper gastrointestinal system screening necessary in kidney transplant candidates?. J Contemp Med. 2023; 13(2): 377-380.