Gastrointestinal disease is common in chronic renal failure. There is a high incidence of morbidity and mortality due to gastrointestinal abnormalities in this group of patients especially when associated with hemorrhage. This study was conducted among patients at the VMMC dialysis unit to evaluate specific anatomic lesions in the upper gastrointestinal tract of those presenting with signs and symptoms of upper gastrointestinal disorders. Twenty one (21) patients underwent endoscopy using the forward viewing Olympus fiberscope. This procedure was performed by one gastroenterologist with a second to confirm the observation. Biopsies were taken and subjected to histopathologic study.
Majority of the CRF patients included were males (81%), with ages ranging from 44 to 79 years, mean of 66 years. Upper gastrointestinal bleeding was noted in 9 of the 21 patients (42.9%). Age, duration of dialysis and presence of epigastric pain were not significantly related to the incidence of upper gastrointestinal bleeding.
Esophagogastroduodenoscopy showed 13 patients (62%) with mucosal inflammation. Six patients (28%) have ulcers while two patients (10%) have angiodysplasia. Histopathologic findings showed 14 patients with chronic active gastritis, 4 with chronic atrophic gastritis, and 3 with atrophic gastritis and mild dysplasia. (Author)