nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2023-27-4-52-63PCSFQUnefr-2268Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSСтруктура патологии желудочно-кишечного тракта больных, получающих лечение программным гемодиализомThe structure of gastrointestinal tract pathology in patients receiving hemodialysis treatmenthttps://orcid.org/0000-0002-5893-3191ПятченковМ. О.PyatchenkovM. O.

Доцент Пятченков Михаил Олегович - кандидат медицинских наук, старший преподаватель кафедры нефрологии и эфферентной терапии.

194044, Санкт-Петербург, ул. Акад. Лебедева, д. 6. Тел.: +7(812)5424314

Associate professor Mikhail O. Pyatchenkov - MD, PhD, Department of nephrology and blood purifi cation.

194044, St. Petersburg Phone: +7 (812) 5424314

pyatchenkovMD@yandex.ruhttps://orcid.org/0000-0002-9455-1043РумянцевА. Ш.RumyantsevA. Sh.

Профессор Румянцев Александр Шаликович - доктор медицинских наук Санкт-Петербургский ГУ, кафедра факультетской терапии. Первый Санкт-Петербургский ГМУ имени академика И.П. Павлова, кафедра пропедевтики внутренних болезней.

199106, Санкт-Петербург, 21-я линия В.О., д. 8а. Тел.: +7(812)326-03-26 197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8. Тел.: +7(812)234-01-65

Prof. Alexandr Sh. Rumyantsev - MD, PhD, DMedSci, Saint-Petersburg SU; Department of Faculty therapy Pavlov Saint-Petersburg SU, Department of Propaedeutics of Internal Diseases.

199106, St. Petersburg; 197022 Saint Petersburg, Leo Tolstoy str. 6-8. Phone: +7 (812) 3260326

rash.56@mail.ruhttps://orcid.org/0000-0003-4839-9578СаликоваС. П.SalikovaS. P.

Доцент Саликова Светлана Петровна доктор медицинских наук, 2-я кафедра терапии усовершенствования врачей.

194044, Санкт-Петербург, ул. Акад. Лебедева, д. 6.  Тел.: +7 (812) 5424314

Associate professor Svetlana P. Salikova - MD, PhD, DMedSci, 2nd Therapy department of postgraduate education.

194044, St. Petersburg. Phone: +7 (812) 5424314

salikova.1966@bk.ruhttps://orcid.org/0000-0002-3045-1721ЩербаковЕ. В.SherbakovE. V.

Щербаков Евгений Вячеславович - клиника нефрологии и эфферентной терапии, врач-нефролог.

194044, Санкт-Петербург, ул. Акад. Лебедева, д. 6. Тел.: +7 (812) 5424314

Evgeniy V.Scherbakov - MD, Department of nephrology and blood purifi -cation, nephrologist.

194044, St. Petersburg. Phone: +7 (812) 5424314

evgenvmeda@mail.ruhttps://orcid.org/0009-0009-9243-276XБессоновД. Е.BessonovD. E.

Бессонов Дмитрий Евгеньевич - эндоскопическое отделение Лечебно-диагностического центра, заведующий.

194044, Санкт-Петербург, ул. Акад. Лебедева, д. 6. Тел.: +7 (812) 5424314

Dmitriy E. Bessonov - MD Multidisciplinary Academic clinic, endoscopist.

194044, St. Petersburg, S. M. Kirov Military Medical Academy, Phone: +7 (812) 5424314

vmeda_12@mil.ruhttps://orcid.org/0009-0005-2027-1590ДорощукК. С.DoroshchukK. S.

Студентка Дорощук Ксения Сергеевна

194044, Санкт-Петербург, ул. Акад. Лебедева, д. 6. Тел.: +7 (812) 5424314

Student Ksenia S. Doroshchuk

194044, St. Petersburg, Phone: +7 (812) 5424314

kseniia1001@gmail.comВоенно-медицинская академия имени С.М. КироваРоссияMilitary Medical Academy S.M. KirovRussian FederationСанкт-Петербургский государственный университет; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияSaint-Petersburg state University; Pavlov First Saint-Petersburg State Medical UniversityRussian Federation2023021220232745263Copyright © Пятченков М.О., Румянцев А.Ш., Саликова С.П., Щербаков Е.В., Бессонов Д.Е., Дорощук К.С., 20232023Пятченков М.О., Румянцев А.Ш., Саликова С.П., Щербаков Е.В., Бессонов Д.Е., Дорощук К.С.Pyatchenkov M.O., Rumyantsev A.S., Salikova S.P., Sherbakov E.V., Bessonov D.E., Doroshchuk K.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2268ВВЕДЕНИЕ

ВВЕДЕНИЕ. Для пациентов, получающих лечение программным гемодиализом, характерен широкий спектр сопутствующих заболеваний, включая кардиоваскулярные, минерально-костные, нутриционные, когнитивные, различные метаболические нарушения и анемию. Между тем, патология желудочно-кишечного тракта (ЖКТ) у этой категории больных остается в значительной степени неисследованной.

ЦЕЛЬ

ЦЕЛЬ: изучить структуру патологии ЖКТ у больных, получающих лечение программным гемодиализом.

ПАЦИЕНТЫ И МЕТОДЫ

ПАЦИЕНТЫ И МЕТОДЫ. У 180 гемодиализных больных (102 мужчины, медиана возраста 60[47;68] лет) с помощью опросника GSQ (Gastrointestinal Symptoms Questionnaire) оценены распространенность и степень выраженности гастроинтестинальных симптомов (ГИС), частота и консистенция стула за последний месяц. Также проанализированы результаты ультразвукового исследования (УЗИ), фиброгастродуоденоскопии (ФГДС), комплексного лабораторного обследования.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Общая распространенность ГИС составила 77,2 % (139/180). Наиболее частыми жалобами были запоры и боли в животе, которые отметили, соответственно, 65(46,8 %) и 57(41 %) больных. Наиболее распространенным вариантом частоты стула было одно опорожнение кишечника в день. Чаще всего выявляли третий, четвертый и пятый типы консистенции стула по Бристольской шкале формы кала. При УЗИ органов брюшной полости у 115(63,9 %) больных обнаружены диффузные изменения печени, у 7(3,9 %) – признаки цирроза. Изменения желчного пузыря при УЗИ были представлены аномалиями его формы в 11,1 %, признаками хронического холецистита – в 10 %, конкрементами (сладжем) – в 7,2 %, полипами – в 2,2 % случаев. Диффузные изменения поджелудочной железы, ее стеатоз, псевдокисты и дилатация главного панкреатического протока были диагностированы, соответственно, у 39(21,7 %), 21(11,7 %), 10(5,6 %) и 3(1,7 %) больных. По данным 154 гастроскопий наиболее частой эндоскопической находкой в желудке был хронический поверхностный гастрит, выявленный у 86(55,8 %) обследуемых. Эро зивный гастрит диагностирован у 22(14,3 %), язва желудка – у 3(2,0 %) пациентов. Эндоскопическая патология двенадцатиперстной кишки была представлена поверхностным дуоденитом у 53(34,4 %), эрозивным дуоденитом – у 15(9,7 %), язвой – у 2(1,3 %), рубцовой деформацией луковицы двенадцатиперстной кишки – у 23(14,9 %) пациентов. Сочетанное поражение желудка и двенадцатиперстной кишки встречалось у 88(57,1 %) больных. ФКС была выполнена 56 пациентам, из которых у 15(26,8 %) – отмечались признаки катарального колита (преимущественно сигмоидита), у 2(3,6 %) – выявлен дивертикулит, у 10(17,9 %) – дивертикулез, у 12(21,4 %) – полипы толстой кишки, у 8(14,3 %) – ангиодисплазия слизистой оболочки, у 3(5,4 %) – долихоколон. Несмотря на обилие жалоб и инструментальных находок, значимых отклонений в лабораторных показателях (в том числе, повышение АСТ, АЛТ, общего билирубина, амилазы, липазы) в изучаемой когорте пациентов установлено не было.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Для гемодиализных больных характерна высокая распространенность ГИС и различных патологический изменений ЖКТ, диагностика и лечение которых требуют индивидуального мультидисциплинарного подхода.

BACKGROUND

BACKGROUND. Hemodialysis patients are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, gastrointestinal tract disorders in these patients remains largely unexplored. Patients receiving treatment with programmed hemodialysis are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, the pathology of the gastrointestinal tract in this category of patients remains largely unexplored.

AIM

AIM: to investigate the structure of digestive diseases in patients receiving hemodialysis treatment.

PATIENTS AND METHODS

PATIENTS AND METHODS. This study included 180 hemodialysis patients. The median age was 60[47;68] years. Gastrointestinal Symptoms Questionnaire (GSQ) was used to evaluate gastrointestinal symptoms over the last month. The results of abdomen ultrasound, gastroscopy, colonoscopy, and complex laboratory examination were also analyzed.

RESULTS

RESULTS. The overall prevalence of gastrointestinal symptoms was 77.2 % (139/180). The most frequent complaints were constipation (46.8 %) and abdominal pain (41 %). The most common stool frequency was one bowel action per day. The third, fourth, fifth type of stool according to the Bristol Stool Form Scale were noted by the majority of participants. Abdominal ultrasound revealed diffuse liver changes in 115 (63.9 %), signs of cirrhosis – in 7(3.9 %) patients. Ultrasound pathology of the gallbladder was represented by anomalies of its shape in 11.1 %, signs of chronic cholecystitis – in 10 %, stones (sludge) – in 7.2 %, polyps – in 2.2 % of patients. Diffuse changes in pancreatic parenchyma, steatosis, pseudocysts and dilatation of the main pancreatic duct were diagnosed respectively in 39(21,7 %), 21(11,7 %), 10(5,6 %) and 3(1.7 %) hemodialysis patients. According to 154 gastroscopies, the most common endoscopic finding in the stomach was chronic gastritis, detected in 86(55.8 %) of the subjects. Erosive gastritis was diagnosed in 22(14.3 %), gastric ulcer – in 3(2.0 %) patients. Endoscopic duodenal pathology was represented by erythematous duodenitis in 53(34.4 %), erosive duodenitis in 15(9.7 %), ulcer in 2(1.3 %), duodenal bulb abnormalities in 23(14.9 %) patients. Combined gastric and duodenal lesions were found in 88(57.1 %) patients. Сolonoscopy was performed in 56 patients, of whom 15 (26.8 %) had signs of colitis (mainly sigmoiditis), 2(3.6 %) – diverticulitis, 10(17.9 %) – diverticulosis, 12(21.4 %) – colon polyps, 8(14.3 %) – angiodysplasia mucosa, in 3(5.4 %) – dolichocolon. Despite the abundance of gastrointestinal symptoms and instrumental findings, no significant deviations in laboratory parameters (including an increase in AST, ALT, total bilirubin, amylase, lipase) were found.

CONCLUSION

CONCLUSION. Hemodialysis patients are characterized by a high prevalence of gastrointestinal symptoms and various pathological changes in the gastrointestinal tract, the diagnosis and treatment of which require an individual multidisciplinary approach.

гастроинтестинальные симптомыпатология желудочно-кишечного трактахроническая болезнь почекгемодиализgastrointestinal symptomspathology of the gastrointestinal tractchronic kidney diseasehemodialysisReferencesJager K, Kovesdy C, Langham R et al. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrology, dialysis, transplantation 2019;34(11):1803–1805. https://doi.org/10.1093/ndt/gfz174Jager K, Kovesdy C, Langham R et al. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrology, dialysis, trans-plantation 2019;34(11):1803–1805. https://doi.org/10.1093/ndt/gfz174Costa-Moreira P, Vilas-Boas F, Teixeira Fraga A, Macedo G. Particular aspects of gastroenterological disorders in chronic kidney disease and end-stage renal disease patients: a clinically focused review. Scand J Gastroenterol 2020;55(2):129–138. https://doi.org/10.1080/00365521.2020.1722217Costa-Moreira P, Vilas-Boas F, Teixeira Fraga A, Macedo G. Particular aspects of gastroenterological disorders in chronic kidney disease and end-stage renal disease patients: a clini-cally focused review. Scand J Gastroenterol 2020;55(2):129–138. https://doi.org/10.1080/00365521.2020.1722217Rocco M, Gassman J, Wang S, Kaplan R. Cross-sectional study of quality of life and symptoms in chronic renal disease patients: the Modification of Diet in Renal Disease Study. Am J Kidney Dis 1997;29(6):888–896. https://doi.org/10.1016/s0272-6386(97)90463-7Rocco M, Gassman J, Wang S, Kaplan R. Cross-sectional study of quality of life and symptoms in chronic renal disease patients: the Modification of Diet in Renal Disease Study. Am J Kidney Dis 1997;29(6):888–896. https://doi.org/10.1016/s0272-6386(97)90463-7Chong V. Impact of duration of hemodialysis on gastro-intestinal symptoms in patients with end stage renal failure. J Gastrointestin Liver Dis 2010;19(4):462–463Chong V. Impact of duration of hemodialysis on gastro-intestinal symptoms in patients with end stage renal failure. J Gastrointestin Liver Dis 2010;19(4):462–463Lee Y, Hung S, Wang H et al. Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemodialysis or Peritoneal Dialysis or With Non-End Stage Renal Disease: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2015;94(36):e1482. https://doi.org/10.1097/MD.0000000000001482Lee Y, Hung S, Wang H et al. Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemo-dialysis or Peritoneal Dialysis or With Non-End Stage Renal Disease: A Nationwide Population-Based Cohort Study. Medi-cine (Baltimore) 2015;94(36):e1482. https://doi.org/10.1097/MD.0000000000001482Shirazian S, Radhakrishnan J. Gastrointestinal disorders and renal failure: exploring the connection. Nat Rev Nephrol 2010;6(8):480–492. https://doi.org/10.1038/nrneph.2010.84Shirazian S, Radhakrishnan J. Gastrointestinal disorders and renal failure: exploring the connection. Nat Rev Nephrol 2010;6(8):480–492. https://doi.org/10.1038/nrneph.2010.84Рысс ЕС, Лутошкин МБ. Активные методы лечения хронической почечной недостаточности и патология верхних отделов желудочно-кишечного тракта (клинико-эндоскопические сопоставления). Нефрология 1997;1(1):27–32. https://doi.org/10.24884/1561-6274-1997-1-1-27-32Ryss ES, Lutoshkin MB. Active methods of chronic renal failure treatment and upper gastrointestinal tract pathology (clinical endoscopic studies). Nephrology (Saint-Petersburg) 1997;1(1):27–32. (In Russ.) ht tps://doi.org/10.24884/1561-6274-1997-1-1-27-32Dong R, Guo ZY, Ding JR et al. Gastrointestinal symptoms: a comparison between patients undergoing peritoneal dialysis and hemodialysis. World J Gastroenterol 2014;20(32):11370–11375. https://doi.org/10.3748/wjg.v20.i32.11370Dong R, Guo ZY, Ding JR et al. Gastrointestinal symptoms: a comparison between patients undergoing peritoneal dialysis and hemodialysis. World J Gastroenterol 2014;20(32):11370–11375. https://doi.org/10.3748/wjg.v20.i32.11370Bossola M, Tazza L, Giungi S, Luciani G. Anorexia in hemodialysis patients: an update. Kidney Int 2006;70(3):417–422. https://doi.org/10.1038/sj.ki.5001572Bossola M, Tazza L, Giungi S, Luciani G. Anorexia in he-modialysis patients: an update. Kidney Int 2006;70(3):417–422. https://doi.org/10.1038/sj.ki.5001572Carrero JJ, Aguilera A, Stenvinkel P et al. Appetite disorders in uremia. J Ren Nutr 2008;18(1):107–113. https://doi.org/10.1053/j.jrn.2007.10.022Carrero JJ, Aguilera A, Stenvinkel P et al. Appetite dis-orders in uremia. J Ren Nutr 2008;18(1):107–113. https://doi.org/10.1053/j.jrn.2007.10.022Bossola M, Luciani G, Rosa F, Tazza L. Appetite and gastrointestinal symptoms in chronic hemodialysis patients. J Ren Nutr 2011;21(6):448–454. https://doi.org/10.1053/j.jrn.2010.09.003Bossola M, Luciani G, Rosa F, Tazza L. Appetite and gas-trointestinal symptoms in chronic hemodialysis patients. J Ren Nutr 2011;21(6):448–454. https://doi.org/10.1053/j.jrn.2010.09.003Zuvela J, Trimingham C, Le Leu R et al. Gastrointestinal symptoms in patients receiving dialysis: A systematic review. Nephrology (Carlton) 2018;23(8):718–727. https://doi.org/10.1111/nep.13243Zuvela J, Trimingham C, Le Leu R et al. Gastrointestinal symptoms in patients receiving dialysis: A systematic review. Ne-phrology (Carlton) 2018;23(8):718–727. https://doi.org/10.1111/nep.13243Ruszkowski J, Majkutewicz K, Heleniak Z et al. Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis. J Clin Med 2022;11(21):6363. https://doi.org/10.3390/jcm11216363Ruszkowski J, Majkutewicz K, Heleniak Z et al. Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis. J Clin Med 2022;11(21):6363. https://doi.org/10.3390/jcm11216363Strid H, Simrén M, Johansson A et al. The prevalence of gastrointestinal symptoms in patients with chronic renal failure is increased and associated with impaired psychological general well-being. Nephrol Dial Transplant 2002;17(8):1434–1439. https://doi.org/10.1093/ndt/17.8.1434Strid H, Simrén M, Johansson A et al. The prevalence of gastrointestinal symptoms in patients with chronic renal failure is increased and associated with impaired psychological general well-being. Nephrol Dial Transplant 2002;17(8):1434–1439. https://doi.org/10.1093/ndt/17.8.1434Katalinic L, Premuzic V, Basic-Jukic N et al. Hypoproteinemia as a factor in assessing malnutrition and predicting survival on hemodialysis. J Artif Organs 2019;22(3):230–236. https://doi.org/10.1007/s10047-019-01098-3Katalinic L, Premuzic V, Basic-Jukic N et al. Hypopro-teinemia as a factor in assessing malnutrition and predicting survival on hemodialysis. J Artif Organs 2019;22(3):230–236. https://doi.org/10.1007/s10047-019-01098-3Peery AF, Crockett SD, Murphy CC et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021. Gastroenterology 2022;162(2):621–644. https://doi.org/10.1053/j.gastro.2021.10.017Peery AF, Crockett SD, Murphy CC et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021. Gastroenterology 2022;162(2):621–644. https://doi.org/10.1053/j.gastro.2021.10.017Пятченков МО, Марков АГ, Румянцев АШ. Структурно-функциональные нарушения кишечного барьера и хроническая болезнь почек. Обзор литературы. Часть I. Нефрология 2022;26(1):10–26. https://doi.org/10.36485/1561-6274-2022-26-1-10-26Pyatchenkov MO, Markov AG, Rumyantsev AS. Structural and functional intestinal barrier abnormalities and chronic kidney disease. Literature review. Part I. Nephrology (Saint-Petersburg) 2022;26(1):10–26. (In Russ.) https://doi.org/10.36485/1561-6274-2022-26-1-10-26Пятченков МО, Румянцев АШ, Щербаков ЕВ, Марков АГ. Структурно-функциональные нарушения кишечного барьера и хроническая болезнь почек. Обзор литературы. Часть II. Нефрология 2022;26(2):46–64. https://doi.org/10.36485/1561-6274-2022-26-2-46-64Pyatchenkov MO, Rumyantsev AS, Sherbakov EV, Mar-kov AG. Structural and functional intestinal barrier abnormalities and chronic kidney disease. Literature review. Part II. Nephrol-ogy (Saint-Petersburg) 2022;26(2):46–64. (In Russ.) https://doi.org/10.36485/1561-6274-2022-26-2-46-64De Schoenmakere G, Vanholder R, Rottey S et al. Relationship between gastric emptying and clinical and biochemical factors in chronic haemodialysis patients. Nephrol Dial Transplant 2001;16(9):1850–1855. https://doi.org/10.1093/ndt/16.9.1850De Schoenmakere G, Vanholder R, Rottey S et al. Rela-tionship between gastric emptying and clinical and biochemical factors in chronic haemodialysis patients. Nephrol Dial Transplant 2001;16(9):1850–1855. ht tps://doi.org/10.1093/ndt/16.9.1850Hubalewska A, Stompór T, Płaczkiewicz E et al. Evaluation of gastric emptying in patients with chronic renal failure on continuous ambulatory peritoneal dialysis using 99mTc-solid meal. Nucl Med Rev Cent East Eur 2004;7(1):27–30Hubalewska A, Stompór T, Płaczkiewicz E et al. Evaluation of gastric emptying in patients with chronic renal failure on continu-ous ambulatory peritoneal dialysis using 99mTc-solid meal. Nucl Med Rev Cent East Eur 2004;7(1):27–30Strid H, Simrén M, Stotzer PO et al. Delay in gastric emptying in patients with chronic renal failure. Scand J Gastroenterol 2004;39(6):516–520. https://doi.org/10.1080/00365520410004505Strid H, Simrén M, Stotzer PO et al. Delay in gastric emptying in patients with chronic renal failure. Scand J Gastro-enterol 2004;39(6):516–520. https://doi.org/10.1080/00365520410004505Chong VH, Tan J. Prevalence of gastrointestinal and psychosomatic symptoms among Asian patients undergoing regular hemodialysis. Nephrology (Carlton) 2013;18(2):97–103. https://doi.org/10.1111/nep.12000Chong VH, Tan J. Prevalence of gastrointestinal and psy-chosomatic symptoms among Asian patients undergoing regular hemodialysis. Nephrology (Carlton) 2013;18(2):97–103. https://doi.org/10.1111/nep.12000Locke GR 3rd, Zinsmeister AR, Fett SL et al. Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil 2005;17(1):29–34. https://doi.org/10.1111/j.1365-2982.2004.00581.xLocke GR 3rd, Zinsmeister AR, Fett SL et al. Overlap of gastrointestinal symptom complexes in a US community. Neuro-gastroenterol Motil 2005;17(1):29–34. https://doi.org/10.1111/j.1365-2982.2004.00581.xSalmoirago-Blotcher E, Crawford S, Jackson E et al. Constipation and risk of cardiovascular disease among post-menopausal women. Am J Med 2011;124(8):714–723. https://doi.org/10.1016/j.amjmed.2011.03.026Salmoirago-Blotcher E, Crawford S, Jackson E et al. Constipation and risk of cardiovascular disease among post-menopausal women. Am J Med 2011;124(8):714–723. https://doi.org/10.1016/j.amjmed.2011.03.026Kubota Y, Iso H, Tamakoshi A. Bowel Movement Frequency, Laxative Use, and Mortality From Coronary Heart Disease and Stroke Among Japanese Men and Women: The Japan Collaborative Cohort (JACC) Study. J Epidemiol 2016;26(5):242–248. https://doi.org/10.2188/jea.JE20150123Kubota Y, Iso H, Tamakoshi A. Bowel Movement Frequency, Laxative Use, and Mortality From Coronary Heart Disease and Stroke Among Japanese Men and Women: The Japan Collaborative Cohort (JACC) Study. J Epidemiol 2016;26(5):242–248. https://doi.org/10.2188/jea.JE20150123Sumida K, Molnar MZ, Potukuchi PK et al. Constipation and Incident CKD. J Am Soc Nephrol 2017;28(4):1248–1258. https://doi.org/10.1681/ASN.2016060656Sumida K, Molnar MZ, Potukuchi PK et al. Constipation and Incident CKD. J Am Soc Nephrol 2017;28(4):1248–1258. https://doi.org/10.1681/ASN.2016060656Garrow D, Delegge MH. Risk factors for gastrointestinal ulcer disease in the US population. Dig Dis Sci 2010;55(1):66–72. https://doi.org/10.1007/s10620-008-0708-xGarrow D, Delegge MH. Risk factors for gastrointestinal ulcer disease in the US population. Dig Dis Sci 2010;55(1):66–72. https://doi.org/10.1007/s10620-008-0708-xKang JY, Wu AY, Sutherland IH, Vathsala A. Prevalence of peptic ulcer in patients undergoing maintenance hemodialysis. Dig Dis Sci 1988;33(7):774–778. https://doi.org/10.1007/BF01550962Kang JY, Wu AY, Sutherland IH, Vathsala A. Prevalence of peptic ulcer in patients undergoing maintenance hemodi-alysis. Dig Dis Sci 1988;33(7):774–778. https://doi.org/10.1007/BF01550962El Ghonaimy E, Barsoum R, Soliman M et al. Serum gastrin in chronic renal failure: morphological and physiological correlations. Nephron 1985;39(2):86–94. https://doi.org/10.1159/000183350El Ghonaimy E, Barsoum R, Soliman M et al. Serum gastrin in chronic renal failure: morphological and physi-ological correlations. Nephron 1985;39(2):86–94. https://doi.org/10.1159/000183350Paronen I, Ala-Kaila K, Rantala I et al. Gastric parietal, chief, and G-cell densities in chronic renal failure. Scand J Gastroenterol 1991;26(7):696–700. https://doi.org/10.3109/00365529108998586Paronen I, Ala-Kaila K, Rantala I et al. Gastric parietal, chief, and G-cell densities in chronic renal failure. Scand J Gastro-enterol 1991;26(7):696–700. https://doi.org/10.3109/00365529108998586Khedmat H, Ahmadzad-Asl M, Amini M et al. Gastro-duodenal lesions and Helicobacter pylori infection in uremic patients and renal transplant recipients. Transplant Proc 2007;39(4):1003–1007. https://doi.org/10.1016/j.transproceed.2007.03.034Khedmat H, Ahmadzad-Asl M, Amini M et al. Gastro-duo-denal lesions and Helicobacter pylori infection in uremic patients and renal transplant recipients. Transplant Proc 2007;39(4):1003– 1007. https://doi.org/10.1016/j.transproceed.2007.03.034Lanza FL, Chan FK, Quigley EM. Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009;104(3):728–738. https://doi.org/10.1038/ajg.2009.115Lanza FL, Chan FK, Quigley EM. Practice Parameters Committee of the American College of Gastroenterology. Guide-lines for prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009;104(3):728–738. https://doi.org/10.1038/ajg.2009.115Chang SS, Hu HY. Lower Helicobacter pylori infection rate in chronic kidney disease and end-stage renal disease patients with peptic ulcer disease. J Chin Med Assoc 2014;77(7):354–359. https://doi.org/10.1016/j.jcma.2014.04.004Chang SS, Hu HY. Lower Helicobacter pylori infection rate in chronic kidney disease and end-stage renal disease patients with peptic ulcer disease. J Chin Med Assoc 2014;77(7):354–359. https://doi.org/10.1016/j.jcma.2014.04.004Shin SP, Bang CS, Lee JJ, Baik GH. Helicobacter pylori Infection in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Gut Liver 2019;13(6):628–641. https://doi.org/10.5009/gnl18517Shin SP, Bang CS, Lee JJ, Baik GH. Helicobacter pylori Infection in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Gut Liver 2019;13(6):628–641. https://doi.org/10.5009/gnl18517Sugimoto M, Sakai K, Kita M et al. Prevalence of Helicobacter pylori infection in long-term hemodialysis patients. Kidney Int 2009;75(1):96–103. https://doi.org/10.1038/ki.2008.508Sugimoto M, Sakai K, Kita M et al. Prevalence of Helico-bacter pylori infection in long-term hemodialysis patients. Kidney Int 2009;75(1):96–103. https://doi.org/10.1038/ki.2008.508Luo JC, Leu HB, Hou MC et al. Nonpeptic ulcer, non-variceal gastrointestinal bleeding in hemodialysis patients. Am J Med 2013;126(3):264.e25–32. https://doi.org/10.1016/j.amjmed.2012.09.010Luo JC, Leu HB, Hou MC et al. Nonpeptic ulcer, non-variceal gastrointestinal bleeding in hemodialysis patients. Am J Med 2013;126(3):264.e25–32. https://doi.org/10.1016/j.amjmed.2012.09.010Chalasani N, Cotsonis G, Wilcox CM. Upper gastrointestinal bleeding in patients with chronic renal failure: role of vascular ectasia. Am J Gastroenterol 1996;91(11):2329–2332Chalasani N, Cotsonis G, Wilcox CM. Upper gastrointes-tinal bleeding in patients with chronic renal failure: role of vascular ectasia. Am J Gastroenterol 1996;91(11):2329–2332Tudor S, Dima B, Herlea V et al. Angiodisplazie colonică asociată cu insuficientăi renală cronică [Colonic angiodysplasia in a chronic renal failure patient]. Chirurgia (Bucur) 2006;101(6):629–631Tudor S, Dima B, Herlea V et al. Angiodisplazie colonică asociată cu insuficientăi renală cronică [Colonic angiodysplasia in a chronic renal failure patient]. Chirurgia (Bucur) 2006;101(6):629– 631Ak mal M, Sawelson S, Karubian F, Gadallah M. The prevalence and significance of occult blood loss in patients with predialysis advanced chronic renal failure (CRF), or receiving dialytic therapy. Clin Nephrol 1994;42(3):198–202Ak mal M, Sawelson S, Karubian F, Gadallah M. The prevalence and significance of occult blood loss in patients with predialysis advanced chronic renal failure (CRF), or receiving dialytic therapy. Clin Nephrol 1994;42(3):198–202Sood P, Kumar G, Nanchal R et al Chronic kidney disease and end-stage renal disease predict higher risk of mortality in patients with primary upper gastrointestinal bleeding. Am J Nephrol 2012;35(3):216–224. https://doi.org/10.1159/000336107Sood P, Kumar G, Nanchal R et al Chronic kidney disease and end-stage renal disease predict higher risk of mortality in pa-tients with primary upper gastrointestinal bleeding. Am J Nephrol 2012;35(3):216–224. https://doi.org/10.1159/000336107Cheung J, Yu A, LaBossiere J et al. Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease. Gastrointest Endosc 2010;71(1):44–49. https://doi.org/10.1016/j.gie.2009.04.014Cheung J, Yu A, LaBossiere J et al. Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease. Gas-trointest Endosc 2010;71(1):44–49. https://doi.org/10.1016/j.gie.2009.04.014Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 38(3):316–321. https://doi.org/10.1136/gut.38.3.316Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk as-sessment after acute upper gastrointestinal haemorrhage. Gut 38(3):316–321. https://doi.org/10.1136/gut.38.3.316Parasa S, Navaneethan U, Sridhar AR et al. End-stage renal disease is associated with worse outcomes in hospitalized patients with peptic ulcer bleeding. Gastrointest Endosc 2013;77(4):609–616. https://doi.org/10.1016/j.gie.2012.11.014Parasa S, Navaneethan U, Sridhar AR et al. End-stage renal disease is associated with worse outcomes in hospital-ized patients with peptic ulcer bleeding. Gastrointest Endosc 2013;77(4):609–616. https://doi.org/10.1016/j.gie.2012.11.014Kalman RS, Pedrosa MC. Evidence-based review of gastrointestinal bleeding in the chronic kidney disease patient. Semin Dial 2015;28(1):68–74. https://doi.org/10.1111/sdi.12301Kalman RS, Pedrosa MC. Evidence-based review of gastrointestinal bleeding in the chronic kidney disease patient. Semin Dial 2015;28(1):68–74. https://doi.org/10.1111/sdi.12301Grant CJ, Harrison LE, Hoad CL et al. Patients with chronic kidney disease have abnormal upper gastro-intestinal tract digestive function: A study of uremic enteropathy. J Gastroenterol Hepatol 2017;32(2):372–377. https://doi.org/10.1111/jgh.13458Grant CJ, Harrison LE, Hoad CL et al. Patients with chronic kidney disease have abnormal upper gastro-intestinal tract di-gestive function: A study of uremic enteropathy. J Gastroenterol Hepatol 2017;32(2):372–377. https://doi.org/10.1111/jgh.13458Ohmori T, Konishi H, Nakamura S, Shiratori K. Abnormalities of the small intestine detected by capsule endoscopy in hemodialysis patients. Intern Med 2012;51(12):1455–1460. https://doi.org/10.2169/internalmedicine.51.7190Ohmori T, Konishi H, Nakamura S, Shiratori K. Abnormali-ties of the small intestine detected by capsule endoscopy in he-modialysis patients. Intern Med 2012;51(12):1455–1460. https://doi.org/10.2169/internalmedicine.51.7190Hosoe N, Matsukawa S, Kanno Y et al. Cross-sectional small intestinal surveillance of maintenance hemodialysis patients using video capsule endoscopy: SCHEMA study. Endosc Int Open 2016;4(5):E589–596. https://doi.org/10.1055/s-0042-105203Hosoe N, Matsukawa S, Kanno Y et al. Cross-sectional small intestinal surveillance of maintenance hemodialysis patients using video capsule endoscopy: SCHEMA study. Endosc Int Open 2016;4(5):E589–596. https://doi.org/10.1055/s-0042-105203Bini EJ, Kinkhabwala A, Goldfarb DS. Predictive value of a positive fecal occult blood test increases as the severity of CKD worsens. Am J Kidney Dis 2006;48(4):580–586. https://doi.org/10.1053/j.ajkd.2006.07.002Bini EJ, Kinkhabwala A, Goldfarb DS. Predictive value of a positive fecal occult blood test increases as the severity of CKD worsens. Am J Kidney Dis 2006;48(4):580–586. https://doi.org/10.1053/j.ajkd.2006.07.002Chang SS, Huang N, Hu HY. Patients with end-stage renal disease were at an increased risk of hospitalization for acute diverticulitis. Medicine (Baltimore) 2016;95(39):e4881. https://doi.org/10.1097/MD.0000000000004881Chang SS, Huang N, Hu HY. Patients with end-stage re-nal disease were at an increased risk of hospitalization for acute diverticulitis. Medicine (Baltimore) 2016;95(39):e4881. https://doi.org/10.1097/MD.0000000000004881Duarte-Chavez R, Stoltzfus J, Yellapu V et al. Colonic diverticular disease in autosomal dominant polycystic kidney disease: is there really an association? A nationwide analysis. Int J Colorectal Dis 2021;36(1):83–91. https://doi.org/10.1007/s00384-020-03736-2Duarte-Chavez R, Stoltzfus J, Yellapu V et al. Colonic diverticular disease in autosomal dominant polycystic kidney disease: is there really an association? A nationwide analysis. Int J Colorectal Dis 2021;36(1):83–91. https://doi.org/10.1007/s00384-020-03736-2Scheff RT, Zuckerman G, Harter H et al. Diverticular disease in patients with chronic renal failure due to polycystic kidney disease. Ann Intern Med 1980;92(2 Pt 1):202–204. https://doi.org/10.7326/0003-4819-92-2-202Scheff RT, Zuckerman G, Harter H et al. Diverticular dis-ease in patients with chronic renal failure due to polycystic kidney disease. Ann Intern Med 1980;92(2 Pt 1):202–204. https://doi.org/10.7326/0003-4819-92-2-202Foutch PG. Colonic angiodysplasia. Gastroenterologist 1997;5(2):148–156Foutch PG. Colonic angiodysplasia. Gastroenterologist 1997;5(2):148–156Poralla T. Angiodysplasia in the renal patient: how to diagnose and how to treat? Nephrol Dial Transplant 1998;13(9):2188–2191. https://doi.org/10.1093/ndt/13.9.2188Poralla T. Angiodysplasia in the renal patient: how to diag-nose and how to treat? Nephrol Dial Transplant 1998;13(9):2188– 2191. https://doi.org/10.1093/ndt/13.9.2188Gupta N, Longo WE, Vernava AM 3rd. Angiodysplasia of the lower gastrointestinal tract: an entity readily diagnosed by colonoscopy and primarily managed nonoperatively. Dis Colon Rectum 1995;38(9):979–982. https://doi.org/10.1007/BF02049736Gupta N, Longo WE, Vernava AM 3rd. Angiodysplasia of the lower gastrointestinal tract: an entity readily diagnosed by colo-noscopy and primarily managed nonoperatively. Dis Colon Rectum 1995;38(9):979–982. https://doi.org/10.1007/BF02049736Alvarez L, Puleo J, Balint JA. Investigation of gastrointestinal bleeding in patients with end stage renal disease. Am J Gastroenterol 1993;88(1):30–33Alvarez L, Puleo J, Balint JA. Investigation of gastroin-testinal bleeding in patients with end stage renal disease. Am J Gastroenterol 1993;88(1):30–33Flobert C, Cellier C, Berger A et al. Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis. Am J Gastroenterol 2000;95(1):195–198. https://doi.org/10.1111/j.1572-0241.2000.01644.xFlobert C, Cellier C, Berger A et al. Right colonic involve-ment is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis. Am J Gastroenterol 2000;95(1):195–198. https://doi.org/10.1111/j.1572-0241.2000.01644.xLi SY, Chen YT, Chen TJ et al. Mesenteric ischemia in patients with end-stage renal disease: a nationwide longitudinal study. Am J Nephrol 2012;35(6):491–497. https://doi.org/10.1159/000338451Li SY, Chen YT, Chen TJ et al. Mesenteric ischemia in patients with end-stage renal disease: a nationwide longitu-dinal study. Am J Nephrol 2012;35(6):491–497. https://doi.org/10.1159/000338451Ori Y, Chagnac A, Schwartz A et al. Non-occlusive mesenteric ischemia in chronically dialyzed patients: a disease with multiple risk factors. Nephron Clin Pract 2005;101(2):c87–93. https://doi.org/10.1159/000086346Ori Y, Chagnac A, Schwartz A et al. Non-occlusive mes-enteric ischemia in chronically dialyzed patients: a disease with multiple risk factors. Nephron Clin Pract 2005;101(2):c87–93. https://doi.org/10.1159/000086346Seong EY, Zheng Y, Winkelmayer WC et al. The Relationship between Intradialytic Hypotension and Hospitalized Mesenteric Ischemia: A Case-Control Study. Clin J Am Soc Nephrol 2018;13(10):1517–1525. https://doi.org/10.2215/CJN.13891217Seong EY, Zheng Y, Winkelmayer WC et al. The Relation-ship between Intradialytic Hypotension and Hospitalized Mes-enteric Ischemia: A Case-Control Study. Clin J Am Soc Nephrol 2018;13(10):1517–1525. https://doi.org/10.2215/CJN.13891217Archodovassilis F, Lagoudiannakis EE, Tsekouras DK et al. Nonocclusive mesenteric ischemia: a lethal complication in peritoneal dialysis patients. Perit Dial Int 2007;27(2):136–141Archodovassilis F, Lagoudiannakis EE, Tsekouras DK et al. Nonocclusive mesenteric ischemia: a lethal complication in peritoneal dialysis patients. Perit Dial Int 2007;27(2):136–141Newman LA, Mittman N, Hunt Z, Alfonso AE. Survival among chronic renal failure patients requiring major abdominal surgery. J Am Coll Surg 1999;188(3):310–314. https://doi.org/10.1016/s1072-7515(98)00308-1Newman LA, Mittman N, Hunt Z, Alfonso AE. Survival among chronic renal failure patients requiring major abdominal surgery. J Am Coll Surg 1999;188(3):310–314. https://doi.org/10.1016/s1072-7515(98)00308-1Picazo M, Cuxart M, Sans R et al. Isquemia mesentérica en pacientes en hemodiálisis [Mesenteric ischemia in hemodialysis patients]. Nefrologia 2008;28(2):198–202Picazo M, Cuxart M, Sans R et al. Isquemia mesentérica en pacientes en hemodiálisis [Mesenteric ischemia in hemodialysis patients]. Nefrologia 2008;28(2):198–202Wootton FT, Rhodes DF, Lee WM, Fitts CT. Colonic necrosis with Kayexalate-sorbitol enemas after renal transplantation. Ann Intern Med 1989;111(11):947–949. https://doi.org/10.7326/0003-4819-111-11-947Wootton FT, Rhodes DF, Lee WM, Fitts CT. Colonic necrosis with Kayexalate-sorbitol enemas after renal transplantation. Ann In-tern Med 1989;111(11):947–949. https://doi.org/10.7326/0003-4819-111-11-947Bischel MD, Reese T, Engel J. Spontaneous perforation of the colon in a hemodialysis patient. Am J Gastroenterol 1980; 74(2):182–184Bischel MD, Reese T, Engel J. Spontaneous perforation of the colon in a hemodialysis patient. Am J Gastroenterol 1980; 74(2):182–184Lillemoe KD, Romolo JL, Hamilton SR et al. Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery 1987;101(3):267–272Lillemoe KD, Romolo JL, Hamilton SR et al. Intestinal ne-crosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery 1987;101(3):267–272Harel Z, Harel S, Shah PS et al. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am J Med 2013;126(3):264.e9–24. https://doi.org/10.1016/j.amjmed.2012.08.016Harel Z, Harel S, Shah PS et al. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am J Med 2013;126(3):264.e9–24. https://doi.org/10.1016/j.amjmed.2012.08.016Rashid A, Hamilton SR. Necrosis of the gastrointestinal tract in uremic patients as a result of sodium polystyrene sulfonate (Kayexalate) in sorbitol: an underrecognized condition. Am J Surg Pathol 1997;21(1):60–69. https://doi.org/10.1097/00000478-199701000-00007Rashid A, Hamilton SR. Necrosis of the gastrointestinal tract in uremic patients as a result of sodium polystyrene sulfonate (Kayexalate) in sorbitol: an underrecognized condition. Am J Surg Pathol 1997;21(1):60–69. https://doi.org/10.1097/00000478-199701000-00007Пятченков МО, Саликова СП, Щербаков ЕВ, Власов АА. Состояние микробно-тканевого комплекса кишечника у больных хронической болезнью почек. Вестник Российской Военно-медицинской академии 2023;25(1):155–164. https://doi.org/10.17816/brmma124822Pyatchenkov MO, Salikova SP, Sherbakov EV, Vlasov AA. The state of the intestinal microbial-tissue complex in patients with chronic kidney disease. Bulletin of the Russian Military Medical Academy 2023;25(1):155–164. (In Russ.)] https://doi.org/10.17816/brmma124822Morelli MC, Rendina M, La Manna G et al. Italian Association for the Study of Liver, and the Italian Society of Nephrology. Position paper on liver and kidney diseases from the Italian Association for the Study of Liver (AISF), in collaboration with the Italian Society of Nephrology (SIN). Dig Liver Dis 2021 Jun;53 Suppl 2:S49–S86. https://doi.org/10.1016/j.dld.2021.03.035Morelli MC, Rendina M, La Manna G et al. Italian Associa-tion for the Study of Liver, and the Italian Society of Nephrology. Position paper on liver and kidney diseases from the Italian As-sociation for the Study of Liver (AISF), in collaboration with the Italian Society of Nephrology (SIN). Dig Liver Dis 2021 Jun;53 Suppl 2:S49–S86. https://doi.org/10.1016/j.dld.2021.03.035Добронравов ВА, Дунаева НВ. Поражение почек и хронический вирусный гепатит С. Нефрология 2008;12(4):9–19. https://doi.org/10.24884/1561-6274-2008-12-4-9-19Dobronravov VA, Dunaeva NV. Renal damage and chronic hepatitis C virus. Nephrology (Saint-Petersburg) 2008;12(4):9–19 (In Russ.) https://doi.org/10.24884/1561-6274-2008-12-4-9-19Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011;34(3):274–285. https://doi.org/10.1111/j.1365-2036.2011.04724.xVernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Phar-macol Ther 2011;34(3):274–285. https://doi.org/10.1111/j.1365-2036.2011.04724.xTilg H, Adolph TE, Moschen AR. Multiple Parallel Hits Hypothesis in Nonalcoholic Fatty Liver Disease: Revisited After a Decade. Hepatology 2021;73(2):833–842. https://doi.org/10.1002/hep.31518Tilg H, Adolph TE, Moschen AR. Multiple Parallel Hits Hy-pothesis in Nonalcoholic Fatty Liver Disease: Revisited After a De-cade. Hepatology 2021;73(2):833–842. https://doi.org/10.1002/hep.31518Mantovani A, Petracca G, Beatrice G et al. Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut 2022;71(1):156–162. https://doi.org/10.1136/gutjnl-2020-323082Mantovani A, Petracca G, Beatrice G et al. Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut 2022;71(1):156–162. https://doi.org/10.1136/gutjnl-2020-323082Jin K, Norris K, Vaziri ND. Dysregulation of hepatic fatty acid metabolism in chronic kidney disease. Nephrol Dial Transplant 2013;28(2):313–320. https://doi.org/10.1093/ndt/gfs350Jin K, Norris K, Vaziri ND. Dysregulation of hepatic fatty acid metabolism in chronic kidney disease. Nephrol Dial Transplant 2013;28(2):313–320. https://doi.org/10.1093/ndt/gfs350Yılmaz Ü, İnci A, Özcan E et al. Gallbladder Stone Prevalence and Related Factors in Predialysis Chronic Kidney Disease Patients. Turk J Gastroenterol 2022;33(9):760–766. https://doi.org/10.5152/tjg.2022.22350Yılmaz Ü, İnci A, Özcan E et al. Gallbladder Stone Preva-lence and Related Factors in Predialysis Chronic Kidney Disease Patients. Turk J Gastroenterol 2022;33(9):760–766. https://doi.org/10.5152/tjg.2022.22350Dobosz Ł, Kobiela J, Danielewicz R et al. Gallbladder Pathologies in Kidney Transplant Recipients: Single-Center Experience and a Review of the Literature. Ann Transplant 2018;23:572–576. https://doi.org/10.12659/AOT.909653Dobosz Ł, Kobiela J, Danielewicz R et al. Gallbladder Pathologies in Kidney Transplant Recipients: Single-Center Experi-ence and a Review of the Literature. Ann Transplant 2018;23:572– 576. https://doi.org/10.12659/AOT.909653Lankisch PG, Weber-Dany B, Maisonneuve P, Lowenfels AB. Frequency and severity of acute pancreatitis in chronic dialysis patients. Nephrol Dial Transplant 2008;23(4):1401–1405. https://doi.org/10.1093/ndt/gfm769Lankisch PG, Weber-Dany B, Maisonneuve P, Lowen-fels AB. Frequency and severity of acute pancreatitis in chronic dialysis patients. Nephrol Dial Transplant 2008;23(4):1401–1405. https://doi.org/10.1093/ndt/gfm769Kroner PT, Mareth K, Raimondo M et al. Acute Pancreatitis in Advanced Chronic Kidney Disease and Kidney Transplant Recipients: Results of a US Nationwide Analysis. Mayo Clin Proc Innov Qual Outcomes 2019;3(2):160–168. https://doi.org/10.1016/j.mayocpiqo.2019.03.006Kroner PT, Mareth K, Raimondo M et al. Acute Pancreatitis in Advanced Chronic Kidney Disease and Kidney Transplant Recipi-ents: Results of a US Nationwide Analysis. Mayo Clin Proc Innov Qual Outcomes 2019;3(2):160–168. https://doi.org/10.1016/j.mayocpiqo.2019.03.006Bruno MJ, van Westerloo DJ, van Dorp WT et al. Acute pancreatitis in peritoneal dialysis and haemodialysis: risk, clinical course, outcome, and possible aetiology. Gut 2000;46(3):385–389. h ttps://doi.org/10.1136/gut.46.3.385Bruno MJ, van Westerloo DJ, van Dorp WT et al. Acute pancreatitis in peritoneal dialysis and haemodialysis: risk, clinical course, outcome, and possible aetiology. Gut 2000;46(3):385– 389. h ttps://doi.org/10.1136/gut.46.3.385Gupta A, Yuan ZY, Balaskas EV et al. CAPD and pancreatitis: no connection. Perit Dial Int 1992;12(3):309–316Gupta A, Yuan ZY, Balaskas EV et al. CAPD and pancreatitis: no connection. Perit Dial Int 1992;12(3):309–316Royse VL, Jensen DM, Corwin HL. Pancreatic enzymes in chronic renal failure. Arch Intern Med 1987;147(3):537–539Royse VL, Jensen DM, Corwin HL. Pancreatic enzymes in chronic renal failure. Arch Intern Med 1987;147(3):537–539Shibasaki T, Matsuda H, Ohno I et al Significance of serum lipase in patients undergoing hemodialysis. Am J Nephrol 1996;16(4):309–314. https://doi.org/10.1159/000169015Shibasaki T, Matsuda H, Ohno I et al Significance of serum lipase in patients undergoing hemodialysis. Am J Nephrol 1996;16(4):309–314. https://doi.org/10.1159/000169015Schoenicke G, Grabensee B, Plum J. Dialysis with icodextrin interferes with measurement of serum alpha-amylase activity. Nephrol Dial Transplant 2002;17(11):1988–1992. https://doi.org/10.1093/ndt/17.11.1988Schoenicke G, Grabensee B, Plum J. Dialysis with icodex-trin interferes with measurement of serum alpha-amylase activity. Nephrol Dial Transplant 2002;17(11):1988–1992. https://doi.org/10.1093/ndt/17.11.1988

The authors declare that there are no conflicts of interest present.