GASTROINTESTINAL SYMPTOMS IN PATIENTS RECEIVING DIALYSIS: A SYSTEMATIC REVIEW

J ZUVELA1, A MEADE1,2, C TRIMINGHAM2, S JESUDASON2,3, R LE LEU2,

1Flinders University, Adelaide, SA; 2Central Northern Adelaide Renal and Transplantation Service, Adelaide, SA; 3University of Adelaide, SA

Aim: To describe the prevalence of all Gastrointestinal (GI) symptoms reported by dialysis patients, as well as the tools being used for diagnosis.

Background: GI symptoms are commonly reported in patients having haemodialysis (HD) and peritoneal dialysis (PD) however there are multiple definitions and assessment tools reported in the literature.

Methods: Using the PICO approach (Participants or Population, Intervention or Exposure, Comparison and Outcome), two research questions were formulated to investigate the prevalence of GI symptoms and the tools used to identify GI symptoms in dialysis patients. A comprehensive systematic review was undertaken using six databases (Medline, Embase, PubMed, CINAHL, Psycinfo and Web of Science) between 1996 and 2017. Thirty studies (24 cross sectional, 6 cohort) met the inclusion criteria. Fifteen studies only included HD, five only PD and ten included both dialysis modalities.

Results: GI symptoms were heterogeneous, reporting variable and the prevalence highly dependent on the definitions, inclusion/exclusion criteria, assessment tools and methods used. Medication use and dietary data were poorly reported. The most common tools used were Gastrointestinal Symptom Rating Scale (GSRS), Rome II and Rome III. Constipation was more common in HD patients than PD patients. Indigestion, abdominal pain and reflux were commonly reported in both dialysis modalities.

Conclusions: GI symptoms are highly prevalent in people on dialysis; however the evidence base is limited and further investigation of preventable causes and potential interventions such as medications and diet is required in future research.

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