The prevalence of gastroesophageal reflux disease and reflux esophagitis in dialysis patients: between facts and fiction

The prevalence of gastroesophageal reflux disease (GERD) in end-stage renal disease (ESRD) patients who are on regular hemodialysis (HD) and those who are on peritoneal dialysis (PD) has been a subject of discussion over the past decades. Although, to our knowledge, few studies have compared the prevalence of GERD in both groups of patients, yet most authorities believe that the disease is more prevalent in PD patients. The aim of the current study is to clarify the relation between dialysis modalities and GERD. The study involved 68 ESRD patients who are on regular hemodialysis (group 1) and 71 age- and sex-matched ESRD patients on peritoneal dialysis (group 2). All patients were subjected to esophago-gastroduodenoscopy for proper evaluation. The prevalence of GERD and reflux esophagitis (RE) was similar in the two groups (45.6% vs 47.9.2% and 36.8% vs 39.4% respectively) (P>0.05). The duration of dialysis, serum creatinine of 7 or over, the presence of diabetes mellitus, body mass index of 27 kg/m² or over, smoking and the absence of H. pylori infection were significantly associated with GERD and RE, while the dialysis modality, age, gender, use of nonsteroidal anti-inflammatory drugs, hypoalbuminemia and aspirin use were not. This study shows a similar prevalence of GERD and RE in both HD and PD patients. The duration rather than the modality of dialysis correlated significantly with GERD and RE.