Comparative characteristics of hemostasis system in patients with endstage renal disease admitted for urgent and elective hemodialysis

AIM: To study informative value of 24-h pH monitoring in registration of gastroesophageal and duodenogastroesophageal reflux (GER, DGER) in patients with gastroesophageal reflux disease (GERD) before and after surgical treatment. MATERIAL AND METHODS: A total of 39 GERD patients after laparoscopic fundoplication entered the study: 12 (39%) males and 27 (61%) females, mean age 47.6 +/- 3.2 years. pH monitoring was made with domestic device Gastroscan-24 before operation and one year after it. Esophagogastroscopy and polypositional roentgenoscopy of the upper gastroduodenal tract were made also before operation and after 1-year follow-up. RESULTS: Before operation, mean pH in the gastric body was 1.7 +/- 1.28, De Meester index 40.4 +/- 8.91, esophageal acidity index (EAI) 22.3 +/- 1.59, the number of acid GER 59.2 +/- 9.41, number of DGER 14.3 +/- 3.47. After laparoscopic fundoplication--3.3 +/- 1.52, 8.7 +/- 5.71 (p < 0.05), 2.5 +/- 0.62 (p < 0.05), 24.4 +/- 8.6 (p < 0.05), 6.5 +/- 3.63, respectively. Five patients (12.8%) examined before the operation had clinicoendoscopic picture of GERD, but normal values of De Meester index and EAI. CONCLUSION: 24-h pH monitoring can estimate both gastroesophageal and duodenoesophagogastric refluxes, but esophageal and gastric pH monitoring only are not sufficient for decision on treatment policy. Such decision should be taken individually for each patient after the analysis of the results of complete clinical examination, symptoms and the disease history.