Abstract:
Background: Gastrointestinal (GI) complications are more frequent and vary among different
stages of Chronic Kidney Disease (CKD) patients who receive various treatment plans. Proton
Pump Inhibitors (PPIs) are prescribed to prevent GI complications of CKD patients worldwide.
It is identified as a plausible risk factor for CKD where there is an obvious relationship with a
renal disease development. A higher prevalence of bowel symptoms with mainly abnormal
bowel habits, bloating and abdominal pain are manifested in patients treated with PPIs. The
current study was designed to evaluate whether there is a relationship between PPI usage and
the upper GI complications in pre-dialysis CKD patients.
Objectives: The major objective of the study was to investigate the prevalence of upper GI
symptoms in pre-dialysis CKD patients and to compare the variation of GI symptoms with PPI
usage.
Methodology: This was an observational cross-sectional study conducted in the renal and
dialysis unit, Teaching Hospital Kandy through a researcher administered questionnaire. The
sample consisted of 300 pre-dialysis CKD patients; 243 patients with upper GI symptoms and
57 without upper GI symptoms. The symptoms were identified using 9 items in the
Gastrointestinal Symptom Rating Scale (GSRS) tool.
Results: The overall prevalence of 81% upper GI symptoms was manifested by CKD patients
and bloated stomach was more common. Further, patients on PPI showed 86.7% occurrence of
upper GI symptoms compared to patients were not on PPI (80%). Bloated stomach, rumbling
and burping were more frequent in patients who were on PPI (59%, 43.6% and 43.6%,
respectively). Upper GI symptom scale of CKD patients who were on PPI prevailed a
significant difference compared to patients who were not on PPI (p= 0.0073).
Conclusions: A higher prevalence of upper GI symptoms and variance in upper GI symptoms
were experienced by pre-dialysis CKD patients who were on PPI. Therefore, prescribing PPI for
CKD patients should be concerned and studied in the future.
