The frequencies of disease entities that cause acute abdominal pain in end-stage renal disease: focused on differences between hemodialysis and peritoneal dialysis patients

Kang, Hyo Jung; Ahn, Jung Hwan

J Korean Soc Emerg Med > Volume 31(4); 2020 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2020;31(4): 371-379.

The frequencies of disease entities that cause acute abdominal pain in end-stage renal disease: focused on differences between hemodialysis and peritoneal dialysis patients

Hyo Jung Kang, Jung Hwan Ahn

Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea

Correspondence

Jung Hwan Ahn ,Tel: 031-219-7750, Fax: 031-219-7760, Email: erdrajh@naver.com,

Received: July 17, 2019; Revised: September 10, 2019 Accepted: September 18, 2019. Published online: August 31, 2020.

ABSTRACT

Objective:
The aim of this study was to investigate the frequency of disease entities that cause abdominal pain in endstage renal disease (ESRD) patients who visited an emergency department (ED) and to compare differences in diagnoses between hemodialysis (HD) and peritoneal dialysis (PD) patients.
Method:
This retrospective observational study included 179 ESRD patients over the age of 18 years who visited an ED with abdominal pain from January 2013 to December 2018. All electronic medical record data were collected and reviewed by a single physician.
Results:
The most common pathologies regardless of dialysis methods were peritonitis (n=51, 28.5%), nonspecific abdominal pain (NSAP; n=30, 16.8%), acute gastroenteritis (AGE; n=16, 8.9%), gastritis (n=16, 8.9%), and cholecystitis/biliary colic (n=11, 6.1%). In HD patients, the most common diseases were NSAP (n=25, 22.7%), AGE (n=15, 13.6%), gastritis (n=13, 11.8%), and cholecystitis/biliary colic (n=11, 10.0%). In PD patients, peritonitis (n=47, 68.1%), NSAP (n=5, 7.2%), kidney rupture (n=4, 5.8%), and gastritis (n=3, 4.3%) were the most common. The statistically significant disease entities between the two groups were peritonitis (HD: n=4, 4.6%; PD: n=47, 68.1%; P<0.001), cholecystitis/biliary colic (HD: n=11, 10.0%; PD: n=0, 0%; P=0.007), NSAP (HD: n=22, 22.7%; PD: n=5, 7.2%; P=0.007), and AGE (HD: n=15, 13.6%; PD: n=1, 1.4%; P=0.006).
Conclusion:
In PD patients, peritonitis was the most common disease entity, whereas in HD patients, cholecystitis was relatively more common. Except for these two disease entities, the pathologies between the two groups were similar, with NSAP and AGE being the most common.

Key words: Abdominal pain; Chronic kidney failure; Renal dialysis; Peritoneal dialysis