Popular heartburn drugs linked to gradual yet ‘silent’ kidney damage – Washington University School of Medicine in St. Louis
Our literature review from pub med revealed 8 studies investigating the differences between these two groups of patients (Table 5). The general feeling was that PD patients were more likely to get reflux symptoms [10-14]. HD patients, on the other hand had more constipation [10,14] and abdominal pain [8,15]. This study confirmed the association of abdominal pain with HD, but not other symptoms.
The aetiology is likely to be multifactorial ranging from effect of ESRD and treatment on the GI tract, diet, medications and other co-morbid conditions. A similar study was conducted in 2010 which compared GI and psychosomatic symptoms between HD patients and controls in the same population . This study confirmed that GI symptoms were common among Asian patients but did not make comparisons with appetite nor with PD patients and CKD5-ND patients. The motivation to emulate and improve on the previous study was to provide evidence for a more targeted approach on improving nutrition and well-being in the sub-set of dialysis population that were anorexic and malnourished.
We are now more likely to refer patients to gastroenterology to evaluate and alleviate resistant GI symptoms and to investigate potentially reversible GI tract triggers. Among patients who have end-stage kidney disease, or kidney failure, and are on hemodialysis, hip fracture risk is estimated to be 4 times higher than in the general population. Many patients with kidney failure take medications called proton pump inhibitors (PPIs), which reduce stomach acid production and have been linked with hip fractures in the general population.
Popular in: Urinary Tract Infection
So, what should you do?. Heartburn can be a symptom of many diseases, including gastrointestinal reflux disease (GERD), stomach and duodenal ulcer disease, gall bladder disease, stomach blockage, and diseases of the esophagus. Your doctor is the best person to make the proper diagnosis and recommend the best treatment. If these diseases can be controlled with a short course of PPIs, then long term risk would be reduced.
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The evidence for increased mortality was similar in both PD  and HD  patients. The study also revealed that poor appetite was not limited to dialysis patients as CKD5-ND patients also displayed similar anorexic symptoms, consistent with other studies published . Another study reported that poor appetite affected survival in PD patients but not CKD5-ND patients .
Vesicoureteral reflux (VUR) can also cause an infection, because bacteria can develop in the urine. Without treatment, kidney damage may occur. Read more about how your pharmacist can advise you about over-the-counter medicines and kidney disease. Some, such as St John’s Wort (for low mood), can interact with medicines prescribed for kidney disease. Avoid herbal medicines if you have kidney disease as they can raise blood pressure.
Distributions of GERD as well as age, gender, income, region of residence, and medical comorbidities, such as diabetes mellitus, hypertension, renal disease, hyperlipidemia, and ischemic heart disease, in the 2 groups were examined by Ï‡(2)-tests. Multivariate logistic regression models were used to analyze the associations between MDD and GERD. Gastroesophageal reflux disease (GERD) is a common physical disease among psychiatric patients. We conducted this study to investigate the prevalence and risk of GERD in patients with major depressive disorder (MDD) in Taiwan. The purpose of this study is to determine the prevalence of GERD among chronic kidney disease with peritoneal dialysis and hemodialysis in Korea.
Antral gastritis was more common in the Helicobacter-positive than in the Helicobacter-negative renal patients (P less than 0.01), but the incidence of body gastritis did not differ between them. The Helicobacter-positive patients had lower serum urea levels (P less than 0.01) and higher acid outputs (P less than 0.001) than Helicobacter-negative subjects. All patients had raised fasting serum gastrin levels, which possibly obscured the difference between Helicobacter-positive (283 pg/ml) and -negative (331 pg/ml) patients. We conclude that in chronic renal failure gastric colonization of Helicobacter pylori is not more frequent than usual.
Current understandings of Helicobacter pylori, peptic ulcer and gastroesophageal reflux disease.
Dyspepsia and gastroparesis in chronic renal failure: the role of Helicobacter pylori.
Our local experience indicated that this could be related to non-occlusive mesenteric ischaemia (NOMI) which has been seen in numerous patients under our care. We suspected that this often under-reported phenomenon was particularly prevalent in our HD population due to numerous factors like intra-dialytic hypotension (leading to splanchnic hypoperfusion) and inherent atherosclerotic risks of patients. The interviews were also carried out during or after the time patients had dialysis and this might have inadvertently increased the likelihood of abdominal pain reporting. The researchers also compared people using the drugs once a day with people who used them twice a day.
Instead of gastroendoscopy, QUEST, a structured questionnaire for the assessment of symptomatic GERD, was used to diagnose GERD. We checked the age, sex, body mass index, etiology of renal disease, QUEST score, medication, alcohol consumption, smoking and laboratory data, and compared GERD group with non-GERD group. Proton Pump Inhibitors (PPIs) are very effective in relieving symptoms and healing the esophageal lining in most CKD patients with GERD so Nephrologists often prescribe PPIs for long-term management of acid reflux. However, studies show people who take PPIs long-term or in high doses are more likely to have hip, wrist, and spinal fractures. Hence, you should remain vigilante and aware of the medication’s effects on your body.
The causes of the increase in GERD may include delayed gastric emptying owing to altered myoelectric activity, or perhaps to an increased production of gastric acid, but evidence for the latter is small. Importantly, treating the problem may lead to better nutrition and higher albumin levels, thus improving patient prognosis. Dyspepsia and GORS leading to PPI treatment are common in CRF patients on dialysis.
Acute kidney failure can occur if toxins build up rapidly in the blood because of a loss of kidney function. In severe cases, the patient may need emergency dialysis. Kidney scarring can result in permanent kidney damage, if a UTI is left untreated. Renal scarring is also known as reflux nephropathy. Treatment depends on the patient’s age, overall health and medical history, and the type and severity of the condition.
They found twice-daily use was associated with a 46 percent increased risk of chronic kidney disease, versus a 15 percent increased risk in those taking one daily dose. People who use proton pump inhibitors (PPIs) have a 20 percent to 50 percent higher risk of chronic kidney disease compared with nonusers, said lead author Dr. Morgan Grams, an assistant professor of epidemiology at Johns Hopkins University in Baltimore.