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Kronik böbrek hastalığı olan diyaliz öncesi hastalarda irritabl bağırsak sendromu sıklığı ve ilişkili faktörler

Year 2026, Volume: 65 Issue: 1, 25 - 32, 09.03.2026

Edip Erkuş , İbrahim Güney , Şeyma Kahyaoğlu , Mikail Dağ , Yasin Taşdelen , Fatih Ergül

https://doi.org/10.19161/etd.1588649
https://izlik.org/JA42MY99AY

Abstract

Amaç: Bu çalışmanın amacı, diyaliz almayan kronik böbrek hastalığı (KBH) olan hastalarda irritabl bağırsak sendromu (IBS) sıklığını ve ilişkili faktörleri, ayrıca depresyon ve anksiyete düzeylerini belirlemektir. Ayrıca yaşam kalitesini iyileştirmek için olası önlemleri araştırmak amaçlanmıştır.
Gereç ve Yöntem: Evre III-V prediyaliz KBH'li hastalar, Roma IV kriterlerine göre IBS açısından değerlendirildi. Anksiyete ve depresyon düzeyleri Hamilton Anksiyete ve Depresyon Derecelendirme Ölçekleri kullanılarak değerlendirildi. Hastalar IBS varlığına göre iki gruba ayrıldı.
Bulgular: 154 hastanın 33'ünde (%21,4) IBS varken, 121'inde (%78,6) IBS yoktu. IBS grubunda 5 hastada hiç anksiyete yoktu, 14 hastada hafif ve 14 hastada majör anksiyete vardı. IBS olmayan grupta ise 44 hastada hiç anksiyete yoktu, 52 hastada hafif ve 25 hastada majör anksiyete vardı. İki grup arasında anksiyete düzeylerinde anlamlı bir fark gözlenirken, depresyon düzeylerinde anlamlı bir fark bulunmamıştır. Alt grup analizi de anksiyetede anlamlı bir fark olduğunu ortaya koymuştur. Fosfor bağlayıcılar, kalsiyum kanal blokerleri veya beta blokerlerin kullanımı açısından anlamlı bir fark bulunmazken, ACEI/ARB kullanımı IBS grubunda anlamlı derecede daha yüksekti.
Sonuç: IBS, diyaliz öncesi kronik böbrek hastalığı (KBH) hastalarında genel popülasyona kıyasla daha sık görülmüştür. Anksiyete, IBS hastalarında daha yaygındı ve ACEI/ARB kullanımı, IBS sıklığının artmasıyla ilişkiliydi. IBS, diyalizden önce başlayabileceğinden, diyaliz öncesi kronik böbrek hastalığı (KBH) hastalarının tedavisini yönetirken göz önünde bulundurulmalıdır.

Keywords

ACE inhibitörü ARB Anksiyete depresyon İrritabl bağırsak sendromu

Project Number

no

References

  • Chapter 1: Definition and classification of CKD. Kidney Int Suppl. (2011) 2013; 3:19.).
  • Skorecki K, Green J, Brenner BM. Chronic Kidney Failure (Translated by: Yahya Sağlıker), Braunwald E, Fauci AS, Kasper DL, et al (eds) Harrison Principles of Internal Diseases Nobel Medicine Bookstores Ltd. Sti, McGraw Hill Co, Istanbul 2004 pp: 1551–62
  • Drossman D, Whitehead W, Camilleri, M. Irritable bowel syndrome: A technical review for practice guideline development. Gastroenterology. 1997;112:2120–37
  • American Gastroenterological Association medical position statement: Irritable bowel syndrome. Gastroenterology. 2002;123:2105
  • Strid H, Simren M, Johansson AC, Svedlund J, Samuelsson O, Bjornsson ES. The prevalence of gastrointestinal symptoms in patients with chronic renal failure is increased and associated with impaired psychological general well-being. Nephrol Dial Transplant. 2002;17:1434–9)
  • Cano AE, Ailsa KN, Kang JY, Barnabas A, Eastwood JB. Gastrointestinal symptoms in patients with end-stage renal disease undergoing treatment by hemodialysis or peritoneal dialysis. Am J Gastroenterol. 2007;102:1990–97. doi: 10.1111/j.1572-0241.2007.01321.x. ].
  • Zamani M, Alizadeh-Tabari S, Zamani V. Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2019 Jul;50(2):132-43.
  • Cho HS, Park JM, Lim CH, et al. Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut Liver 2011;5:29-36
  • Sugaya N, Nomura S, Shimada H. Relationship between cognitive factors and anxiety in individuals with irritable bowel syndrome. Int J Behav Med 2012;19:308-15.]
  • .Alander T, Heimer G, Svärdsudd K, Agréus L. Abuse in women and men with and without functional gastrointestinal disorders. Dig Dis Sci2008;53:1856-64. .
  • Palsson OS, Whitehead WE, van Tilburg MA, et al. Rome IV diagnostic question naires and tables for investigators and clinicians. Gastroenterology. 2016;S0016-5085(16):00180-3
  • Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91. doi: 10.1053/j.gastro.2005.11.061.
  • Akdemir, A., Örsel D. S., Dağ İ., Türkçapar M. H., İşcan N., Özbay H. (1996). Validity-reliability and clinical use of the Hamilton depression rating scale. Journal of Psychiatry Psychology Psychopharmacology, 4(4), 251-9.
  • Yazıcı M. K., Demir B., Tanrıverdi N., Karaağaoğlu E.,Yolaç, P. Hamilton Anxiety Rating Scale: Interrater reliability and validity study.Turkish Journal of Psychiatry, 1998. 9: p. 114-7.
  • Mokhtar NM, Bahrudin MF, Abd Ghani N, Abdul Rani R, Raja Ali RA. Prevalence of Subthreshold Depression Among Constipation-Predominant Irritable Bowel Syndrome Patients. Front Psychol. 2020 Aug 6;11:1936.doi: 10.3389/fpsyg.2020.01936.
  • Drossman DA, Creed FH, Olden KW, Svedlund J, Toner BB, Whitehead WE. Psychosocial aspects of the functional gastrointestinal disorders. Gut. 1999 Sep;45 Suppl 2(Suppl 2):II25-30. doi: 10.1136/gut.45.2008.ii25.
  • Mayer E.A., M. Craske, and B.D. Naliboff, Depression, anxiety, and the gastrointestinal system. J Clin Psychiatry, 2001. 62 Suppl 8: p. 28-36.
  • Özkul D, Güney İ, Saçkan F, CoşkunYavuz Y, Selcuk NY, Tonbul HZ. Irritable bowel syndrome frequency and related factors in hemodialysis patients. Hemodial Int. 2020 Jul;24(3):359-66. doi: 10.1111/hdi.12846.
  • Pudrovska T, Karraker A. Gender, job authority, and depression. J Health Soc Behav. 2014 Dec;55(4):424-41. doi: 10.1177/0022146514555223.
  • Basson M, Mezzarobba M, Weill A, et al. Severe intestinal malabsorption associated with olmesartan: a French nationwide observational cohort study. Gut. 2016 Oct;65(10):1664-9. doi: 10.1136/gutjnl-2015-309690.
  • Ianiro G, Bibbò S, Montalto M, Ricci R, Gasbarrini A, Cammarota G. Systematic review: Sprue-like enteropathy associated with olmesartan. Aliment Pharmacol Ther. 2014 Jul;40(1):16-23. doi: 10.1111/apt.12780
  • Talley NJ. Use of olmesartan for ≥ 1 year was associated with hospitalization for intestinal malabsorption. Ann Intern Med 2015; 163:JC13.
  • Keszthelyi D, Dackus GH, Masclee GM, Kruimel JW, Masclee AA. Increased proton pump inhibitor and NSAID exposure in irritable bowel syndrome: results from a case-control study. BMC Gastroenterol. 2012 Sep 5;12:121. doi: 10.1186/1471-230X-12-121.
  • Karahan D, Şahin İ. Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities. BMC Nephrol. 2022 Jul 23;23(1):261. doi: 10.1186/s12882-022-02893-6.
  • Gök EG, İnci A, Çoban M, Kutsal DA, Kürşat S. Functional bowel disorders and associated risk factors in hemodialysis patients in Turkey. Turk J Gastroenterol. 2017 Jan;28(1):12-9. doi: 10.5152/tjg.2016.0415.
  • Fiderkiewicz B, Rydzewska-Rosołowska A, Myśliwiec M, et al. Factors associated with irritable bowel syndrome symptoms in hemodialysis patients. World J Gastroenterol. 2011 Apr 21;17(15):1976-81. doi: 10.3748/wjg.v17.i15.1976.
  • Afsar B, Elsurer R, Yilmaz MI, Eyileten T, Yenicesu M. Irritable bowel syndrome in haemodialysis: Prevalence, link with quality of life and depression. Nephrology (Carlton). 2010 Mar;15(2):197-202. doi: 10.1111/j.1440-1797.2009.01189.x.
  • Saito YA, Schoenfeld P, Locke GR 3rd. The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol. 2002 Aug;97(8):1910-5. doi: 10.1111/j.1572-0241.2002.05913.x.
  • Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008 Jan-Feb;27(1):22-8.
  • Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001 May-Jun;20(3):103-6.
  • Thompson WG, Irvine EJ, Pare P, Ferrazzi S, Rance L. Functional gastrointestinal disorders in Canada: first population-based survey using Rome II criteria with suggestions for improving the questionnaire. Dig Dis Sci. 2002 Jan;47(1):225-35. doi: 10.1023/a:1013208713670.
  • Boyce P.M., N.A. Koloski, N.J. Talley, Irritable bowel syndrome according to varying diagnostic criteria: are the new Rome II criteria 41 unnecessarily restrictive for research and practice? The American journal of gastroenterology, 2000. 95(11): p. 3176-3183.
  • Mearin X.B., A. Balboa, E. Baró, E, et al. Irritable bowel syndrome prevalence varies enormously depending on the employed diagnostic criteria: comparison of Rome II versus previous criteria in a general population. Scandinavian journal of gastroenterology, 2001. 36(11): p. 1155-61.
  • Drossman D.A., An integrated approach to the irritable bowel syndrome. Alimentary pharmacology & therapeutics, 1999. 13: p. 3-14.
  • Kahvecioglu S, Akdag I, Kiyici M, et al. High prevalence of irritable bowel syndrome and upper gastrointestinal symptoms in patients with chronic renal failure. J Nephrol. 2005 Jan-Feb;18(1):61-6.
  • Özden A., Köksal A. Ş., Oğuz D.,etal.The frequency of irritable bowel syndrome in primary care centers of Turkey. The Turkish Journal of Academic Gastroenterology, 2006. 5(1): p. 4-15.

The frequency of irritable bowel syndrome in predialysis patients with chronic kidney disease and its associated factors

Year 2026, Volume: 65 Issue: 1, 25 - 32, 09.03.2026

Edip Erkuş , İbrahim Güney , Şeyma Kahyaoğlu , Mikail Dağ , Yasin Taşdelen , Fatih Ergül

https://doi.org/10.19161/etd.1588649
https://izlik.org/JA42MY99AY

Abstract

Aim: This study aimed to determine the frequency of irritable bowel syndrome (IBS) and associated factors, as well as the levels of depression and anxiety, in patients with chronic kidney disease (CKD) not receiving dialysis. It also aimed to explore potential measures to improve quality of life.
Materials and Methods: Patients with stage III–V predialysis CKD were assessed for IBS based on the Rome IV criteria. Anxiety and depression levels were evaluated using the Hamilton Anxiety and Depression Rating Scales. Patients were divided into two groups based on the presence of IBS.
Results: Among 154 patients, 33 (21.4%) had IBS and 121 (78.6%) did not. In the IBS group, 5 patients had no anxiety, 14 had mild, and 14 had major anxiety. In the non-IBS group, 44 had no anxiety, 52 had mild, and 25 had major anxiety. A significant difference in anxiety levels was observed between the two groups, but no significant difference was found in depression levels. Subgroup analysis also revealed a significant difference in anxiety. While no significant differences were found regarding the use of phosphate binders, calcium channel blockers, or beta-blockers, ACE inhibitor/ARB use was significantly higher in the IBS group.
Conclusion: IBS was more frequent in predialysis CKD patients compared to the general population. Anxiety was more common in IBS patients, and ACEI/ARB use was associated with increased IBS frequency. IBS can begin before dialysis, so it should be considered when managing treatment in predialysis CKD patients.

Keywords

ACE inhibitor ARB Anxiety depression Irritable bowel syndrome

Project Number

no

References

  • Chapter 1: Definition and classification of CKD. Kidney Int Suppl. (2011) 2013; 3:19.).
  • Skorecki K, Green J, Brenner BM. Chronic Kidney Failure (Translated by: Yahya Sağlıker), Braunwald E, Fauci AS, Kasper DL, et al (eds) Harrison Principles of Internal Diseases Nobel Medicine Bookstores Ltd. Sti, McGraw Hill Co, Istanbul 2004 pp: 1551–62
  • Drossman D, Whitehead W, Camilleri, M. Irritable bowel syndrome: A technical review for practice guideline development. Gastroenterology. 1997;112:2120–37
  • American Gastroenterological Association medical position statement: Irritable bowel syndrome. Gastroenterology. 2002;123:2105
  • Strid H, Simren M, Johansson AC, Svedlund J, Samuelsson O, Bjornsson ES. The prevalence of gastrointestinal symptoms in patients with chronic renal failure is increased and associated with impaired psychological general well-being. Nephrol Dial Transplant. 2002;17:1434–9)
  • Cano AE, Ailsa KN, Kang JY, Barnabas A, Eastwood JB. Gastrointestinal symptoms in patients with end-stage renal disease undergoing treatment by hemodialysis or peritoneal dialysis. Am J Gastroenterol. 2007;102:1990–97. doi: 10.1111/j.1572-0241.2007.01321.x. ].
  • Zamani M, Alizadeh-Tabari S, Zamani V. Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2019 Jul;50(2):132-43.
  • Cho HS, Park JM, Lim CH, et al. Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut Liver 2011;5:29-36
  • Sugaya N, Nomura S, Shimada H. Relationship between cognitive factors and anxiety in individuals with irritable bowel syndrome. Int J Behav Med 2012;19:308-15.]
  • .Alander T, Heimer G, Svärdsudd K, Agréus L. Abuse in women and men with and without functional gastrointestinal disorders. Dig Dis Sci2008;53:1856-64. .
  • Palsson OS, Whitehead WE, van Tilburg MA, et al. Rome IV diagnostic question naires and tables for investigators and clinicians. Gastroenterology. 2016;S0016-5085(16):00180-3
  • Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91. doi: 10.1053/j.gastro.2005.11.061.
  • Akdemir, A., Örsel D. S., Dağ İ., Türkçapar M. H., İşcan N., Özbay H. (1996). Validity-reliability and clinical use of the Hamilton depression rating scale. Journal of Psychiatry Psychology Psychopharmacology, 4(4), 251-9.
  • Yazıcı M. K., Demir B., Tanrıverdi N., Karaağaoğlu E.,Yolaç, P. Hamilton Anxiety Rating Scale: Interrater reliability and validity study.Turkish Journal of Psychiatry, 1998. 9: p. 114-7.
  • Mokhtar NM, Bahrudin MF, Abd Ghani N, Abdul Rani R, Raja Ali RA. Prevalence of Subthreshold Depression Among Constipation-Predominant Irritable Bowel Syndrome Patients. Front Psychol. 2020 Aug 6;11:1936.doi: 10.3389/fpsyg.2020.01936.
  • Drossman DA, Creed FH, Olden KW, Svedlund J, Toner BB, Whitehead WE. Psychosocial aspects of the functional gastrointestinal disorders. Gut. 1999 Sep;45 Suppl 2(Suppl 2):II25-30. doi: 10.1136/gut.45.2008.ii25.
  • Mayer E.A., M. Craske, and B.D. Naliboff, Depression, anxiety, and the gastrointestinal system. J Clin Psychiatry, 2001. 62 Suppl 8: p. 28-36.
  • Özkul D, Güney İ, Saçkan F, CoşkunYavuz Y, Selcuk NY, Tonbul HZ. Irritable bowel syndrome frequency and related factors in hemodialysis patients. Hemodial Int. 2020 Jul;24(3):359-66. doi: 10.1111/hdi.12846.
  • Pudrovska T, Karraker A. Gender, job authority, and depression. J Health Soc Behav. 2014 Dec;55(4):424-41. doi: 10.1177/0022146514555223.
  • Basson M, Mezzarobba M, Weill A, et al. Severe intestinal malabsorption associated with olmesartan: a French nationwide observational cohort study. Gut. 2016 Oct;65(10):1664-9. doi: 10.1136/gutjnl-2015-309690.
  • Ianiro G, Bibbò S, Montalto M, Ricci R, Gasbarrini A, Cammarota G. Systematic review: Sprue-like enteropathy associated with olmesartan. Aliment Pharmacol Ther. 2014 Jul;40(1):16-23. doi: 10.1111/apt.12780
  • Talley NJ. Use of olmesartan for ≥ 1 year was associated with hospitalization for intestinal malabsorption. Ann Intern Med 2015; 163:JC13.
  • Keszthelyi D, Dackus GH, Masclee GM, Kruimel JW, Masclee AA. Increased proton pump inhibitor and NSAID exposure in irritable bowel syndrome: results from a case-control study. BMC Gastroenterol. 2012 Sep 5;12:121. doi: 10.1186/1471-230X-12-121.
  • Karahan D, Şahin İ. Comparison of gastrointestinal symptoms and findings in renal replacement therapy modalities. BMC Nephrol. 2022 Jul 23;23(1):261. doi: 10.1186/s12882-022-02893-6.
  • Gök EG, İnci A, Çoban M, Kutsal DA, Kürşat S. Functional bowel disorders and associated risk factors in hemodialysis patients in Turkey. Turk J Gastroenterol. 2017 Jan;28(1):12-9. doi: 10.5152/tjg.2016.0415.
  • Fiderkiewicz B, Rydzewska-Rosołowska A, Myśliwiec M, et al. Factors associated with irritable bowel syndrome symptoms in hemodialysis patients. World J Gastroenterol. 2011 Apr 21;17(15):1976-81. doi: 10.3748/wjg.v17.i15.1976.
  • Afsar B, Elsurer R, Yilmaz MI, Eyileten T, Yenicesu M. Irritable bowel syndrome in haemodialysis: Prevalence, link with quality of life and depression. Nephrology (Carlton). 2010 Mar;15(2):197-202. doi: 10.1111/j.1440-1797.2009.01189.x.
  • Saito YA, Schoenfeld P, Locke GR 3rd. The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol. 2002 Aug;97(8):1910-5. doi: 10.1111/j.1572-0241.2002.05913.x.
  • Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008 Jan-Feb;27(1):22-8.
  • Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001 May-Jun;20(3):103-6.
  • Thompson WG, Irvine EJ, Pare P, Ferrazzi S, Rance L. Functional gastrointestinal disorders in Canada: first population-based survey using Rome II criteria with suggestions for improving the questionnaire. Dig Dis Sci. 2002 Jan;47(1):225-35. doi: 10.1023/a:1013208713670.
  • Boyce P.M., N.A. Koloski, N.J. Talley, Irritable bowel syndrome according to varying diagnostic criteria: are the new Rome II criteria 41 unnecessarily restrictive for research and practice? The American journal of gastroenterology, 2000. 95(11): p. 3176-3183.
  • Mearin X.B., A. Balboa, E. Baró, E, et al. Irritable bowel syndrome prevalence varies enormously depending on the employed diagnostic criteria: comparison of Rome II versus previous criteria in a general population. Scandinavian journal of gastroenterology, 2001. 36(11): p. 1155-61.
  • Drossman D.A., An integrated approach to the irritable bowel syndrome. Alimentary pharmacology & therapeutics, 1999. 13: p. 3-14.
  • Kahvecioglu S, Akdag I, Kiyici M, et al. High prevalence of irritable bowel syndrome and upper gastrointestinal symptoms in patients with chronic renal failure. J Nephrol. 2005 Jan-Feb;18(1):61-6.
  • Özden A., Köksal A. Ş., Oğuz D.,etal.The frequency of irritable bowel syndrome in primary care centers of Turkey. The Turkish Journal of Academic Gastroenterology, 2006. 5(1): p. 4-15.
There are 36 citations in total.

Details

Primary Language English
Subjects Gastroenterology and Hepatology, Nefroloji, Psychiatry
Journal Section Research Article
Authors

Edip Erkuş 0000-0002-7821-8275

İbrahim Güney 0000-0002-1646-2811

Şeyma Kahyaoğlu 0009-0001-0667-4036

Mikail Dağ 0000-0002-8039-9036

Yasin Taşdelen 0000-0003-4985-0690

Fatih Ergül 0000-0001-7498-9710

Project Number no
Submission Date November 22, 2024
Acceptance Date October 17, 2025
Publication Date March 9, 2026
DOI https://doi.org/10.19161/etd.1588649
IZ https://izlik.org/JA42MY99AY
Published in Issue Year 2026 Volume: 65 Issue: 1

Cite

Vancouver 1.Edip Erkuş, İbrahim Güney, Şeyma Kahyaoğlu, Mikail Dağ, Yasin Taşdelen, Fatih Ergül. The frequency of irritable bowel syndrome in predialysis patients with chronic kidney disease and its associated factors. EJM. 2026 Mar. 1;65(1):25-32. doi:10.19161/etd.1588649

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