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胃食管反流病(GERD)是最常见的食管疾病之一。多项研究表明,终末期肾病(ERSD)患者GERD的患病率高于普通人群。目前对于ERSD患者特别是血液透析患者GERD的症状特点及严重程度的研究较少。ESRD患者常并发或伴发糖尿病、高血压等,而糖尿病神经病变可影响胃排空功能,钙拮抗剂和硝酸酯类药物可影响LES舒张功能。透析相关淀粉样变通过影响食管蠕动、食管下段括约肌张力和胃排空影响GERD的发生。ERSD患者中,相当比例的患者全身状况不佳,行胃镜风险较高,常常应用标准化量表或质子泵抑制剂诊断试验评估患者症状性GERD患病情况。ESRD及透析患者GERD的知晓率仍较低,部分患者自行服用碳酸氢钠等非一线药物控制症状。理论上对于ESRD及透析患者伴随的GERD进行早期诊断和治疗可能提高患者生活质量,并减少水钠摄入,改善血压及透析间期体重增加,降低心血管事件风险,具体的临床获益仍有待进一步研究证实。
Gastroesophageal reflux disease (GERD) is one of the most common esophageal diseases. A number of studies have shown that the prevalence of GERD in patients with end-stage renal disease (ERSD) is higher than in the general population. Currently, there are few studies on the characteristics and severity of GERD in patients with ERSD, especially in hemodialysis patients. ESRD patients often complicated by or associated with diabetes, hypertension, etc., and diabetic neuropathy can affect gastric emptying function, calcium antagonists and nitrates can affect LES diastolic function. Dialysis-related amyloidosis affects the incidence of GERD by affecting esophageal peristalsis, lower esophageal sphincter tone and gastric emptying. A significant proportion of patients with ERSD have poor generalized health and a higher risk of gastroscopy. Patients with symptomatic GERD are often assessed using standardized scales or proton pump inhibitor diagnostic tests. The prevalence of GERD in ESRD and dialysis patients is still low, and some patients take their own non-first-line drugs such as sodium bicarbonate to control their symptoms. In theory, early diagnosis and treatment of GERD associated with ESRD and dialysis patients may improve the quality of life of patients and reduce sodium and water intake, improve blood pressure and increase weight during dialysis, and reduce the risk of cardiovascular events. The specific clinical benefit remains Further research confirmed.