Gastrointestinal Symptoms among Patients with Chronic Kidney Disease

2019 ◽  
Vol 36 (3-4) ◽  
pp. 649-658
Author(s):  
Ahmed M. Hamdy ◽  
Magid A. A. F. Ibrahim ◽  
Ragia M. Said ◽  
Doha A. Anwar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gastrointestinal Symptoms

scholarly journals Dietary Habits, Vitamin and Mineral Supplements in Patients with Chronic Kidney Disease (CKD)

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3817
Author(s):  
Piergiorgio Messa
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dietary Habits ◽  
Gastrointestinal Symptoms ◽  
Mineral Supplements

Chronic kidney disease (CKD) is frequently complicated with a malnutrition status, due to the presence of gastrointestinal symptoms and/or to dietary and multi pharmacological prescriptions which are almost universally present in such patients [...]

Effect of prebiotic (fructooligosaccharide) on uremic toxins of chronic kidney disease patients: a randomized controlled trial

2018 ◽  
Vol 34 (11) ◽  
pp. 1876-1884 ◽  
Author(s):  
Christiane Ishikawa Ramos ◽  
Rachel Gatti Armani ◽  
Maria Eugenia Fernandes Canziani ◽  
Maria Aparecida Dalboni ◽  
Carla Juliana Ribeiro Dolenga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Controlled Trial ◽  
Gastrointestinal Symptoms ◽  
Uremic Toxins ◽  
Trophic Factors ◽  
Secondary Outcome ◽  
Model Assessment ◽  
Double Blind ◽  
The Difference

Abstract Background Microbial-derived uremic toxins, p-cresyl sulfate (PCS), indoxyl sulfate (IS) and indole 3-acetic acid (IAA), have been associated with the burden of chronic kidney disease (CKD). Prebiotics have emerged as an alternative to modulate the gut environment and to attenuate toxin production. This trial aims to investigate the effect of a prebiotic fructooligosaccharide (FOS) on uremic toxins of non-dialysis-dependent CKD (NDD-CKD) patients. Methods A double-blind, placebo-controlled, randomized trial was conducted for 3 months. In all, 50 nondiabetic NDD-CKD patients [estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2], aged 18–80 years, were allocated to prebiotic (FOS, 12 g/day) or placebo (maltodextrin, 12 g/day) groups. Primary outcomes were changes in serum (total and free) and urinary (total) PCS. Secondary outcomes included changes in IS, IAA, serum markers of intestinal permeability (zonulin), gut-trophic factors (epidermal growth factor and glucagon-like peptide-2), eGFR, inflammation (high sensitive c-reactive protein and interleukin-6), homeostatic model assessment-insulin resistance, lipid profile and gastrointestinal symptoms. Results From 50 participants (54% men, 57.3 ± 14.6 years and eGFR 21.4 ± 7.6 mL/min/1.73 m2), 46 completed the follow-up. No changes in dietary intake or gastrointestinal symptoms were observed. There was a trend in the difference of serum total ΔPCS (treatment effect adjusted for baseline levels: −12.4 mg/L; 95% confidence interval (−5.6 to 0.9 mg/L; P = 0.07) and serum-free Δ%PCS [intervention −8.6 (−41.5 to 13.9%) versus placebo 3.5 (−28.8 to 85.5%); P = 0.07] between the groups. The trend in the difference of serum total ΔPCS was independent of eGFR and dietary protein:fiber ratio intake. No difference was found in urinary PCS. Aside from the decreased high-density lipoprotein cholesterol in the intervention, no differences were observed in the change of IS, IAA or other secondary outcome between the groups. Conclusions Our result suggests the potential of FOS in reducing serum total and free PCS in nondiabetic NDD-CKD patients.

scholarly journals Does Intragastric Balloon Treatment for Obesity in Chronic Kidney Disease Heighten Acute Kidney Injury Risk?

2016 ◽  
Vol 44 (6) ◽  
pp. 411-418 ◽  
Author(s):  
Helen L. MacLaughlin ◽  
Iain C. Macdougall ◽  
Wendy L. Hall ◽  
Tracy Dew ◽  
Konstantinos Mantzoukis ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Body Mass ◽  
Intragastric Balloon ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
Obese Patients ◽  
Increased Risk

Background: The outcomes of intragastric balloon (IGB) placement to achieve weight loss in obese patients with chronic kidney disease (CKD) have not been reported to date. This study aimed to assess the safety and efficacy of the IGB as a weight-loss treatment among this patient population. Methods: A prospective, single-arm, ‘first in CKD' interventional study was conducted in patients with a body mass index >35 kg/m2 and CKD stages 3-4, referred for weight loss. After clinical assessment, the IGB was endoscopically inserted into the stomach and kept in place for 6 months. Complications, adverse events, acceptability, weight loss and metabolic responses were monitored over 6 months. Results: Eleven participants were recruited over 18 months. Two patients withdrew (1 prior to IGB insertion and 1 early removal after 3 days due to persistent vomiting) from the study; 9 patients completed the study. There were 5 episodes of acute kidney injury (AKI), occurring in 3 patients. After 6 months, the mean body mass decreased by 9.6% (SD ±6.8). Median waist circumference and total cholesterol decreased significantly (-7.7 cm; interquartile range (IQR) -15.3 to -3.9; and -0.2 mmol/l; IQR -0.6 to -0.05, respectively), with no changes in estimated glomerular filtration rate, blood pressure, triglycerides, adipokines, inflammation, or arterial stiffness measured by carotid-femoral pulse wave velocity. At IGB removal, there was 1 new case each of gastritis and esophagitis. Conclusions: Treatment with IGB has only moderate efficacy on weight loss; yet it results in a high rate of complications in obese patients with established CKD. The risk of AKI may be raised due to increased risk of dehydration secondary to gastrointestinal symptoms associated with IGB placement and reduced baseline kidney function.

scholarly journals Basal Gastric Acid level in Patients of Chronic Kidney Disease

2017 ◽  
Vol 12 (1) ◽  
pp. 10-14
Author(s):  
Nilima Jafrin ◽  
Nayeema Akter ◽  
Shahin Akhter ◽  
Md Myenuddin Mozumder ◽  
Sakhawat Mahmud Khan
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Kidney Disease ◽  
Gastric Acid ◽  
Gastric Juice ◽  
Kidney Diseases ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Ph Level

Background: Gastrointestinal symptoms are common in patients with chronic kidney disease (CKD). Chronic renal failure is associated with an increased incidence of acid-related gastrointestinal disorders.Objective: To determine the pH level of gastric acid in patients of CKD and to correlate the different stages of CKD with gastric acid status.Methods: This study was carried out in the Department of Physiology and Nephrology, Chittagong Medical College and Hospital during January 2008 to December 2008. Total 87 subjects were included in this study, of them 65 patients of diagnosed case of chronic kidney diseases were selected as study group. Age and sex matched 22 apparently healthy persons were selected as control group To assess gastric juice media gastric juice pH level was determined with the help of Model pHs -25 pH meter. Data were analyzed by Chi-square test, Student’s t-test and Pearson’s correlation co-efficient test where applicable.Results: Mean gastric juice pH level of CKD patients was lower than that of control group but it was not statistically significant. Again, pH level of gastric juice was significantly (p<0.001) decreased according to severity of CKD patients. Gradual decrease of pH level was found with the increasing severity of the CKD.Conclusion: In this study gastric juice pH was lowered in patients of chronic kidney disease which was significantly lowered in stage V. So it can be concluded that the gastric acid secretion may increase in chronic renal failure patient.Bangladesh Soc Physiol. 2017, June; 12(1): 10-14

scholarly journals Nutcracker syndrome complicated with intestinal malrotation

2019 ◽  
Vol 12 (10) ◽  
pp. e231230
Author(s):  
Yosuke Nishio ◽  
Yoshihiko Kawano ◽  
Shinya Hara
Keyword(s):  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Kidney Disease ◽  
Mesenteric Artery ◽  
Surgical Intervention ◽  
Pathological Condition ◽  
Left Renal Vein ◽  
Gastrointestinal Symptoms ◽  
Intestinal Malrotation ◽  
Nutcracker Syndrome

Nutcracker syndrome (NCS) is a pathological condition in which the left renal vein (LRV) is compressed between the superior mesenteric artery (SMA) and aorta. NCS can predispose patients to the onset of chronic kidney disease because of persistent increase in LRV pressure. Although NCS in children is often idiopathic, it can also be caused by underlying pathologies such as retroperitoneal tumours. To the best of our knowledge, there have been no reports regarding paediatric cases of NCS complicated with intestinal malrotation. Here, we report the case of a 12-year-old girl with intestinal malrotation complicated with NCS whose haematuria resolved after surgical intervention for intestinal malrotation. The present case findings indicate that intestinal malrotation with concomitant weight loss is a potential underlying aetiology in NCS. Thus, when NCS is especially diagnosed with gastrointestinal symptoms, intestinal malrotation should be considered as an underlying aetiology.

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