Federal University of Ceara, Brazil
Title: Dyspepsia: An underestimated problem among end-stage renal disease patients
Paulo Roberto Santos is Associate Professor at Federal University of Ceará, Brazil, and coordinates the Graduate Program in Health Sciences of the Sobral Faculty of Medicine. His main research interests are self-perceived outcomes (quality of life, depression, coping and sexuality) among end-stage renal disease patients.
Dyspepsia is one of the most common symptoms among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Nonetheless, there is little information about the pathophysiological mechanisms involved in dyspepsia and its impact on patients’ quality of life. We produced some evidence on this topic, placing side-by-side clinical assessments of dyspepsia and an experiment to measure gastric motility in a sample of ESRD patients on HD in the Dialysis Unit of Santa Casa Hospital, in Sobral, northeast Brazil. Dyspepsia was assessed using a validated Brazilian version of a standardized questionnaire named the Porto Alegre Dyspeptic Symptoms Questionnaire. Quality of life was evaluated using a validated Brazilian version of the SF-36. The octanoic acid breath test using 13 carbon was employed to assess the gastric emptying time. Based on the test, gastric emptying time was estimated by calculating the t1/2 (t1/2 being the time in minutes to metabolize the first half of the 13 carbon in the test meal). According to our results, more than half of the patients were dyspeptics. Regarding the impact of dyspepsia on quality of life, we found that patients with dyspepsia presented lower scores (worse quality of life) related to bodily pain, vitality, role-emotional and mental health, compared to non-dyspeptics. Regarding gastric motility, gastric emptying time was longer among dyspeptics compared to non-dyspeptics. Moreover, the t1/2 was positively correlated with dyspepsia score, indicating that the longer the gastric emptying time is, the more severe the dyspeptic symptoms tend to be. Based on our findings, dyspepsia should be considered a target for efforts to improve the quality of life of HD patients. And, due to the association between dyspepsia and gastric emptying delay, prokinetics can be tried in cases of proven functional dyspepsia when other treatments of dyspeptic symptoms are not successful.
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