Gastroesophageal reflux and hyperacidity in chronic renal failure.

The prevalence of H. pylori infection and PUD seem not to be different in CRF patients as compared with the general population. However, PUD in CRF patients seems to have some unique features-namely, lack of pain and higher associations with bleeding, with post-bulbar location, and with multiple ulcers. No increase in GERD has been proven in adults, but several studies demonstrate increased GERD in pediatric CRF patients. The causes of the increase in GERD may include delayed gastric emptying owing to altered myoelectric activity, or perhaps to an increased production of gastric acid, but evidence for the latter is small. Importantly, treating the problem may lead to better nutrition and higher albumin levels, thus improving patient prognosis.