Appetite and Gastrointestinal Symptoms in End Stage Renal Disease Patients

Poor appetite and gastrointestinal symptoms are common amongst dialysis patients. Often, this can lead to protein energy wasting, malnutrition and adverse outcomes. This study attempted to investigate the occurrence of these symptoms in haemodialysis (HD), peritoneal dialysis (PD), pre-dialysis chronic kidney disease (CKD5-ND) and control participants.  There were 306 participants in this study; 106 HD, 50 PD, 50 CKD5-ND and 100 control participants. Gastrointestinal symptoms were experienced by 81%, 72% and 51% of all End Stage Renal Disease (ESRD), CKD5-ND and control patients respectively (p<0.05). Poor appetite was reported by 10%, 26% and 1% of ESRD, CKD5-ND and control patients respectively (p<0.05). HD patients experienced more abdominal pain than PD patients and CKD5-ND patients were more likely to have dysgeusia. The occurrence of GI symptoms was not related to clinical variables (serum haemoglobin, albumin, urea and creatinine) but poor appetite was significantly associated to lower levels of serum urea and creatinine in dialysis patients (p<0.05). The presence of diabetes mellitus was associated with the development of GI symptoms, but not hypertension. This study has raised awareness of the varied demographics of patients with poor appetite and gastrointestinal symptoms and measures have been implemented to improve appetite and gastrointestinal symptoms through focused and concerted efforts by doctors, nurses, nutritionists and dieticians. It is hoped that such measures might be beneficial in improving long term prognosis and quality of life of dialysis and CKD patients.