Marshall University School of Medicine Huntington, WV
Xiaoliang Wang, MD, PhD1, Jiayan Wang, MD, PhD1, Hafiz Zarsham Ali Ikram, MD1, Wesam Frandah, MD2, Gengqing Song, MD3 1Marshall University School of Medicine, Huntington, WV; 2Marshall University Joan C. Edwards School of Medicine, Huntington, WV; 3MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
Introduction: Patients with chronic kidney disease (CKD) often experience gastric symptoms such as nausea, vomiting, epigastric pain, and early satiety. However, there is limited available data on the relationship between specific organic gastric diseases and CKD. This study aimed to investigate the association between different stages of CKD and the risk of developing gastritis, gastric polyps, peptic ulcer disease (PUD), and helicobacter pylori infection (HPI).
Methods: We conducted a retrospective population-based analysis using data from the National Inpatient Sample, involving 7,159,694 patients. The study aimed to compare the occurrence of gastric diseases between patients with and without CKD, focusing on specific organic gastric diseases. Gastritis, gastric polyps, PUD, and HPI were diagnosed based on ICD-10-CM codes. Functional gastric diseases like gastroparesis and gastroesophageal reflux disease were excluded. Confounding factors were accounted for through adjustments for age, sex, and race. Bivariate analyses, including appropriate statistical tests (chi-squared or Fisher exact test, two-tailed), assessed differences in categorical variables.
Results: Patients with CKD and organic gastric diseases tended to be older compared to those without CKD. There was a higher prevalence of gastritis (2.36% vs. 1.37%, p< 0.01) and gastric polyps (22.9 vs. 9.4 per 10,000 patients, p< 0.01) among CKD patients as compared to non-CKD patients. The increased prevalence of gastritis and gastric polyps was consistently observed across all stages of CKD, with the highest prevalence in the late stages. After adjusting for other factors, CKD patients also had a higher risk of developing gastritis (OR: 1.215, p< 0.01) and gastric polyps (OR: 1.435, p< 0.01) compared to non-CKD patients. Similarly, the presence of gastritis and gastric polyps was more pronounced in the late stages of CKD with the highest risk of gastritis (OR: 1.653, p< 0.01) and gastric polyps (OR: 2.034, p< 0.01) found in patients with ESRD . However, no significant association was found between any stage of CKD and PUD or HPI.
Discussion: We found that patients with CKD are associated with a higher prevalence of gastritis, and gastric polyps, particularly in the late stages of CKD. These findings underscore the importance of considering CKD as a potential risk factor for gastritis and gastric polyps. Further research is warranted to elucidate the underlying mechanisms and develop targeted interventions for this vulnerable patient population.
Figure: A, Graphical abstract of the study, B, Sample selection and study design flow chat. C. Demographic characterize, risk factors and comorbidities , prevalence and odds ratio for CKD patients with gastritis. D, Demographic characterize, risk factors and comorbidities Prevalence and odds ratio for CKD patients with gastric polyps. E, Demographic characterize, risk factors and comorbidities, prevalence and odds ratio for CKD patients with peptic ulcer disease and H. Pylori infection. CKD, chronic kidney disease; OR, odds ratio; ESRD, end-stage renal disease, HTN, Hypertension, HLD, Hyperlipidemia, T2DM, type 2 diabetes, * p<0.05; ** p<0.01.
Disclosures:
Xiaoliang Wang indicated no relevant financial relationships.
Jiayan Wang indicated no relevant financial relationships.
Hafiz Zarsham Ali Ikram indicated no relevant financial relationships.
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