Prevalence and associated clinical factors of Gastro-esophageal Reflux Disease in Filipino Hemodialysis patients: A cross sectional study

ABSTRACT

Introduction@#Reflux is one of the most common gastrointestinal symptoms among dialysis patients. This may be associated with several clinical factors such as comorbidities and subsequent polypharmacy. However, this remains unrecognized and untreated.@*Objectives@# The objectives of this study were to determine the prevalence of Gastroesophageal Reflux Disease (GERD) in Filipino patients on maintenance hemodialysis (HD) and to investigate associated demographic, clinical, and renal profiles of HD patients with and without GERD.@*Methods@#This was a cross-sectional, multicenter study using a validated GERD questionnaire (GERDQ) translated into Filipino. Patients above 18 years old undergoing hemodialysis as outpatients were included. Several clinical factors such as demographic, clinical, and renal profiles were analyzed based on the absence and presence of GERD with a predetermined cut-off value of eight or above.@*Results@#Included in our analysis were 264 patients, from which 36 had GERDQ score of ≥ 8 (13.64% 95%CI 9.98-18.35). Factors associated with having score of ≥ 8 included the following (1) having chronic heart disease or CHD (COR 4.041, 95%CI 1.89-8.64, p<0.001), (2) being on insulin (COR 2.599, 95%CI 1.25-5.42, p=0.011), (3) anemia (COR 4.508, 95%CI 1.91-10.64, p=0.001) (4) diagnosis of both hypertensive kidney disease and diabetes kidney disease (COR 3.853, 95%CI 1.15-12.96, p=0.029), (5) previous diagnosis of GERD (COR 6.655, 95%CI 3.18-13.91, p<0.001), (6) previous intake of antacids (COR 2.622, 95%CI 1.17-5.89, p=0.020), (7) being employed (COR 2.332, 95%CI 1.15-4.75, p=0.020) (8) alcohol consumption (COR 2.477, 95%CI 1.23-5.01, p=0.012), and (9) smoking (COR 2.405, 95%CI 1.19-4.86, p=0.014).@*Conclusion@#In our study, the prevalence of GERD in Filipino HD patients was 13.64% and may be associated with several clinical factors such as heart disease, insulin use, anemia, hypertension, diabetic kidney disease, previous diagnosis of GERD, use of antacids, being employed, smoking, and alcohol use. A comprehensive understanding of the relationships between these clinical factors awaits further studies in a larger number of patients.