Prevalence and associated clinical factors of GERD (Gastro-esophageal Reflux Disease) in Filipino hemodialysis patients: A Cross-sectional study

Abstract

Objectives: This study aimed to determine the prevalence of gastro-esophageal reflux disease (GERD) in Filipino patients on maintenance hemodialysis (HD) and investigate the demographic, clinical, and renal profiles of HD patients with and without GERD.

Methodology: This was a cross-sectional, multicenter study using a validated GERD questionnaire (GERDQ) with a Filipino translation. Patients above 18 years-old undergoing hemodialysis as outpatients were included. A GERDQ score of ≥8 was regarded as having GERD. Logistic regression analysis was conducted using variables that exhibited a significant correlation coefficient on two group comparisons as factors, with the presence or absence of GERD as the dependent variable.

Results: Included in our analysis were 264 patients, from which 36 had a GERDQ score of ≥8 (13.64% 95%CI 9.98-18.35). Factors associated with having a score of ≥8 include the following: (1) having CHD (COR 4.041, 95%CI 1.89-8.64, p<0.001), (2) being on insulin (COR 2.599, 95%CI 1.25-5.42, p=0.011), (3) anemia (COR 4.508, 95%CI 1.91-10.64, p=0.001), (4) diagnosis of both HTNKD and DKD (COR 3.853, 95%CI 1.15-12.96, p=0.029), (5) previous diagnosis of GERD (COR 6.655, 95%CI 3.18-13.91, p<0.001), (6) previous intake of antacids (COR 2.622, 95%CI 1.17-5.89, p=0.020), (7) those employed (COR 2.332, 95%CI 1.15-4.75, p=0.020), (8) alcohol
consumption (COR 2.477, 95%CI 1.23-5.01, p=0.012), and (9) smoking (COR 2.405, 95%CI 1.19-4.86, p=0.014).

Conclusion: The prevalence of GERD in Filipino HD patients from three centers in Tarlac City was 13.64% and may be associated with several clinical factors such as heart disease, insulin use, anemia, hypertensive and diabetic kidney disease, previous diagnosis of GERD, use of antacids, with employment, smoking, and alcohol use. A comprehensive understanding of the relationship among these clinical factors awaits further studies in a larger number of patients.