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Renal Transplant Alıcılarında Gastroözefageal Reflü Hastalığı Belirtilerinin Değerlendirilmesi

Yıl 2019, Cilt: 41 Sayı: 2, 141 - 146, 01.04.2019
https://doi.org/10.20515/otd.464077

Öz

Gastrointestinal semptomlar,
özellikle retrosternal yanma ve regürjitasyon, son dönem böbrek  hastalarında (SDBH)  ve renal transplant alıcılarında sık görülen
bulgulardır. Kronik böbrek hastalarında ve böbrek nakli yapılan hastalarda
gastroözofageal reflü hastalığının (GÖRH) prevalansı son birkaç yıldır
tartışılmaya başlamıştır. Ülkemizde renal transplant alıcılarında GÖRH
prevelansı araştırılmamıştır. Bu çalışmada renal transplant alıcılarında GÖRH
sıklığını ve ilişkili olduğu faktörleri araştırmayı amaçladık. Kesitsel tipteki
bu çalışmaya 69 fonksiyone grefte sahip renal transplant alıcısı hasta dahil
edildi. Hastaların gastrointestinal sistem şikayetleri, özgeçmiş özellikleri ve
kullandıkları ilaçlar yüz yüze görüşme yöntemi ile elde edildi. Anket formu,
bireylerin sosyodemografik özelliklerini, GÖRH ile ilişkili olduğu düşünülen
bazı faktörler ile ilgili soruları içermekteydi. Çalışmada GÖRH’ün
değerlendirilmesinde National İnstitutes of Health (NIH) PROMİS GERD Ölçeği
kullanıldı. Çalışmaya dahil edilen hastaların 32’si (%46.4) erkek, 37’si
(%53.6) ise kadındı. Hastaların yaşları 22-66 arasında değişmekte olup, yaş
ortalamaları 44.86±11.26 yıl idi. Hastalarda GÖRH sıklığı %21.7 oranında tespit
edildi. Hastaların %79.7’si gastroprotektif ajan kullanmakta idi. GÖRH
olanlarla olmayanlar arasında yaş, cinsiyet, vücut kitle indeksi, glomeruler
filtrasyon hızı (eGFR), sigara kullanımı, medeni durum, gastroprotektif ilaç
kullanımı, nonsteroid antienflamatuar ilaç kullanımı, donor kaynağı (canlı,
kadavra), nakil öncesi diyaliz süresi, eğitim durumu açısından fark bulunmadı
(p>0.05). Renal transplant alıcılarında GÖRH sıklığı %21.7 bulunmuş olup, bu
oranın genel Türk popülasyonu ile karşılaştırıldığında (%33.9) düşük, Türk
hemodiyaliz hasta popülasyonu ile karşılaştırıldığında(%14) yüksek olduğu
tesbit edilmiştir.

Kaynakça

  • KAYNAKLAR1.Kamar N, Oufroukhi L, Faure P, et al. Questionnaire-based evaluation of gastrointestinal disorders in de novo renal-transplant patients receiving either mycophenolate mofetil or enteric-coated mycophenolate sodium. Nephrol Dial Transplant .2005; 20: 2231.2. Budde K, Curtis J, Knoll G, et al. Enteric-coated mycophenolate sodium can be safely administered in maintenance renal transplant patients:Results of a 1-year study. Am J Transplant.2004; 4: 237.3. Salvadori M, Holzer H, de Mattos A, et al. Enteric-coated mycophenolate sodium is therapeutically equivalent to mycophenolate mofetil in de novo renal transplant patients. Am J Transplant. 2004; 4: 231.4.Bayerdoerffer E, Miehlke S, Lehan E. Chronic type B gastritis as an important denominator of peptic ulcer healing. Eur J Gastroenterol Hepatol. 1993;5:99-105.5. Ala-Kaila K. Upper gastrointestinal findings in chronic renal failure. Scand J Gastroenterol. 1987;22:372-6.6. Abdulrahman IS, Al-Quorain AA. Prevalence of gastroesophageal reflux disease and its association with Helicobacter pylori infection in chronic renal failure patients and in renal transplant recipients.Saudi J Gastroenterol. 2008 Oct;14(4):183-6. 7. Spiegel BM, Hays RD, Bolus R, Melmed GY, Chang L, Whitman C, et al. Development of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) gastrointestinal symptom scales. Am J Gastroenterol. 2014;109:1804–14.8. Özseker B, Yasar NF, Bilgin M, Kurt Y, Balcioglu H, Bilge U. Turkish validation of National Institutes of Health (NIH) patient- reported outcomes measurement information system (PROMISÂŪ) Gastroesophageal Reflux Disease (GERD) scale. Biomedical Research.2016;27:577–81.9. Helderman JH, Goral S. Gastrointestinal complications of transplant immunosuppression. J Am Soc Nephrol. 2002; 13: 277.10. Oğuz D, Köksal AŞ, Özden A. The frequency of gastroesophageal reflux disease in patients admitting to primary health care centers in Turkey. Akademik Gastroenteroloji Dergisi. 2008;7:137–43.11.Fock KM, Talley N, Hunt R, Fass R, Nandurkar S, Lam SK, et al. Report of the Asia-Pacific consensus on the management of gastroesophageal reflux disease. J Gastroenterol Hepatol. 2004;19:357-67.12. Segal I. The gastro-oesophageal reflux disease complex in sub-Saharan Africa. Eur J Cancer Prev. 2001;10:209–12. 13. Fung WP. Gastric acid secretion in Chinese with particular reference to the dose of histamine required for maximal stimulation. Gut. 1970;11:955–61. 14. El-Serag HB, Sonnenberg A, Jamal MM, Inadomi JM, Crooks LA, Feddersen RM. Corpus gastritis is protective against reflux oesophagitis. Gut. 1999;45:181–5. 15. Kang JY, Ho KY. Different prevalences of reflux oesophagitis and hiatus hernia among dyspeptic patients in England and Singapore. Eur J Gastroenterol Hepatol. 1999;11:845–50.16. Bor S, Mandiracioglu A, Kitapcioglu G, Caymaz-Bor C, Gilbert RJ. Gastroesophageal reflux disease in a low-income region in Turkey. Am J Gastroenterol. 2005;100(4):759-65.17. Luca Neri, Lisa A. Rocca Rey, Brett W. Pinsky, Krista L. Et.al. Increased Risk of Graft Failure in Kidney Transplant Recipients After a Diagnosis of Dyspepsia or Gastroesophageal Reflux Disease. Transplantation. 2008;85: 344–352.18. Sultan Özkurt, Yasemin Sağlan, Handan Gölgeli, Ramazan Sağlan, Hüseyin Balcıoğlu, Uğur Bilge, İlhami Ünlüoğlu. Hemodiyaliz Hastalarında Gastroözefageal Reflü Hastalığı Sıklığının Değerlendirilmesi. Haydarpasa Numune Med J. 2017;57(3):167–171. 19. Locke GR, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ.Locke GR . Risk factors associated with symptoms of gastroesophageal reflux. AmJ Med. 1999;106(6):642-9.20. Bortolotti M, Labriola E, Bacchelli S, et al. “Oesophageal angina” in patients with angina pectoris: A possible side effect of chronic therapy with nitroderivates and Ca-antagonists. Ital J Gastroenterol. 1992;24(7):405-8.

Evaluation of Gastroesophageal Reflux Disease Symptoms in Renal Transplant Recipients

Yıl 2019, Cilt: 41 Sayı: 2, 141 - 146, 01.04.2019
https://doi.org/10.20515/otd.464077

Öz

Gastrointestinal symptoms,
especially heartburn and regurgitation, are common findings in end-stage renal
disease (ESRD) and renal transplant recipients. The prevalence of
gastroesophageal reflux disease (GERD) in patients with chronic kidney disease
and renal transplantation has been debated over the last few years. In our
country, the prevalence of GERD in renal transplant recipients has not been
investigated. In this study, we aimed to investigate the frequency and associated
factors of GERD in renal transplant recipients. 69 renal transplant recipients
patients who have funtional graft included in this cross-sectional study.
Gastrointestinal complaints of the patients, resume characteristics and the medication
they used were obtained by face to face interview method. The questionnaire
included questions about the sociodemographic characteristics of individuals
and some factors that were thought to be related to gastroesophageal reflux
disease (GERD). The National Institute of Health (NIH) PROMIS GERD Scale was
used to assess gastroesophageal reflux disease in the study. 32 patients
(46.4%) were male and 37 (53.6%) were female in this study. The ages of the
patients ranged from 22 to 66 years and the mean age was 44.86 ± 11.26 years.
The incidence of GERD was 21.7% in patients. 79.7% of the patients were using
gastroprotective agent. There was no difference among those who have GERD and
not in terms of age, sex, body mass index, glomerular filtration rate (eGFR),
smoking status, marital status, gastroprotective drug use, nonsteroidal
antiinflammatory drug use, donor source (live, cadaver) ), duration of dialysis
before transplantation, education status (p>0.05). GERD frequency in renal
transplant recipients was found to be 21.7% and when compared with the general
Turkish population (33.9%) it is low, when compared with the Turkish
hemodialysis patient population (14%) it is high.

Kaynakça

  • KAYNAKLAR1.Kamar N, Oufroukhi L, Faure P, et al. Questionnaire-based evaluation of gastrointestinal disorders in de novo renal-transplant patients receiving either mycophenolate mofetil or enteric-coated mycophenolate sodium. Nephrol Dial Transplant .2005; 20: 2231.2. Budde K, Curtis J, Knoll G, et al. Enteric-coated mycophenolate sodium can be safely administered in maintenance renal transplant patients:Results of a 1-year study. Am J Transplant.2004; 4: 237.3. Salvadori M, Holzer H, de Mattos A, et al. Enteric-coated mycophenolate sodium is therapeutically equivalent to mycophenolate mofetil in de novo renal transplant patients. Am J Transplant. 2004; 4: 231.4.Bayerdoerffer E, Miehlke S, Lehan E. Chronic type B gastritis as an important denominator of peptic ulcer healing. Eur J Gastroenterol Hepatol. 1993;5:99-105.5. Ala-Kaila K. Upper gastrointestinal findings in chronic renal failure. Scand J Gastroenterol. 1987;22:372-6.6. Abdulrahman IS, Al-Quorain AA. Prevalence of gastroesophageal reflux disease and its association with Helicobacter pylori infection in chronic renal failure patients and in renal transplant recipients.Saudi J Gastroenterol. 2008 Oct;14(4):183-6. 7. Spiegel BM, Hays RD, Bolus R, Melmed GY, Chang L, Whitman C, et al. Development of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) gastrointestinal symptom scales. Am J Gastroenterol. 2014;109:1804–14.8. Özseker B, Yasar NF, Bilgin M, Kurt Y, Balcioglu H, Bilge U. Turkish validation of National Institutes of Health (NIH) patient- reported outcomes measurement information system (PROMISÂŪ) Gastroesophageal Reflux Disease (GERD) scale. Biomedical Research.2016;27:577–81.9. Helderman JH, Goral S. Gastrointestinal complications of transplant immunosuppression. J Am Soc Nephrol. 2002; 13: 277.10. Oğuz D, Köksal AŞ, Özden A. The frequency of gastroesophageal reflux disease in patients admitting to primary health care centers in Turkey. Akademik Gastroenteroloji Dergisi. 2008;7:137–43.11.Fock KM, Talley N, Hunt R, Fass R, Nandurkar S, Lam SK, et al. Report of the Asia-Pacific consensus on the management of gastroesophageal reflux disease. J Gastroenterol Hepatol. 2004;19:357-67.12. Segal I. The gastro-oesophageal reflux disease complex in sub-Saharan Africa. Eur J Cancer Prev. 2001;10:209–12. 13. Fung WP. Gastric acid secretion in Chinese with particular reference to the dose of histamine required for maximal stimulation. Gut. 1970;11:955–61. 14. El-Serag HB, Sonnenberg A, Jamal MM, Inadomi JM, Crooks LA, Feddersen RM. Corpus gastritis is protective against reflux oesophagitis. Gut. 1999;45:181–5. 15. Kang JY, Ho KY. Different prevalences of reflux oesophagitis and hiatus hernia among dyspeptic patients in England and Singapore. Eur J Gastroenterol Hepatol. 1999;11:845–50.16. Bor S, Mandiracioglu A, Kitapcioglu G, Caymaz-Bor C, Gilbert RJ. Gastroesophageal reflux disease in a low-income region in Turkey. Am J Gastroenterol. 2005;100(4):759-65.17. Luca Neri, Lisa A. Rocca Rey, Brett W. Pinsky, Krista L. Et.al. Increased Risk of Graft Failure in Kidney Transplant Recipients After a Diagnosis of Dyspepsia or Gastroesophageal Reflux Disease. Transplantation. 2008;85: 344–352.18. Sultan Özkurt, Yasemin Sağlan, Handan Gölgeli, Ramazan Sağlan, Hüseyin Balcıoğlu, Uğur Bilge, İlhami Ünlüoğlu. Hemodiyaliz Hastalarında Gastroözefageal Reflü Hastalığı Sıklığının Değerlendirilmesi. Haydarpasa Numune Med J. 2017;57(3):167–171. 19. Locke GR, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ.Locke GR . Risk factors associated with symptoms of gastroesophageal reflux. AmJ Med. 1999;106(6):642-9.20. Bortolotti M, Labriola E, Bacchelli S, et al. “Oesophageal angina” in patients with angina pectoris: A possible side effect of chronic therapy with nitroderivates and Ca-antagonists. Ital J Gastroenterol. 1992;24(7):405-8.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Sultan Özkurt Bu kişi benim 0000-0001-7552-2186

Yasemin Sağlan Bu kişi benim 0000-0002-5066-0432

Çiğdem Mengüş Bu kişi benim 0000-0002-4355-9731

Yayımlanma Tarihi 1 Nisan 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 41 Sayı: 2

Kaynak Göster

Vancouver Özkurt S, Sağlan Y, Mengüş Ç. Renal Transplant Alıcılarında Gastroözefageal Reflü Hastalığı Belirtilerinin Değerlendirilmesi. Osmangazi Tıp Dergisi. 2019;41(2):141-6.


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