Abstract

Patients with CKD exhibit upper gastrointestinal symptoms e.g. nausea, vomiting, anorexia, hiccups, haematemesis. These may vary from mild symptoms to life threatening GI bleeding; endoscopy timely diagnose most of these abnormalities to intervene accordingly. The incidence of GI symptoms can largely be attributed to the underlying conditions such as accumulation of uraemic toxins, effect of dialysis, impaired gut barrier function due to gut-dysbiosis, inflammation, immunological dysfunction and increased bleeding risk via uraemic-coagulopathy. Aims and objective: Study the prevalence of upper GI-endoscopic lesions in CKD. Assorted lesions; their correlation with clinical, biochemical parametres and comorbities. Methods: Present Observational Cross-sectional study was carried out in Nephrology Unit whereas endoscopies were done at Endoscopy Room, Medicine Department, M.L.B. Medical College, Jhansi (UP). 100 patients of Bundelkhand Region were enrolled in the study during a period of March 2021 to Aug 2022 on the patients with CKD as per inclusion and exclusion criteria. Results: Most patients in the study untreated and undiagnosed with duration <3months, had UGI-lesions, those with duration >3months under treatment and diagnosed 86.66% had lesions. ESKD is significantly related with UGI-lesions (89%). Most had inflammatory lesions (erosions, oedema, erythema) followed by haemorrhagic (bleeding ulcers) and non-haemorrhagic (clean-based ulcers, healing ulcers). Gastric lesions (74%) were most common followed by oesophageal (39%) and duodenal (18%). Conclusion: Patients with high serum creatinine level and ESKD develop UGI-lesions; routine endoscopic evaluation may help in early diagnosis and intervention of the life threatening ones. Risk factors like diabetes, hypertension, obstructive uropathy in most CKD patients are related with UGI-lesions; restriction reduces prevalence. Anaemia perse iron deficiency due to blood loss and malabsorption is significant.

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