**8. Conclusion**

Dyspepsia is highly prevalent among ESRD patients undergoing HD. It can affect central aspects, like QOL and nutritional status. The division of FD into PDS and EDS is didactic but not reasonable in clinical practice. The fact is that most dyspeptic patients present symptoms of both syndromes. Treatment is known to be ineffective. Therapy directed toward the main physiopathological pathways can be crucial, yet the pathogenesis of FD in ESRD remains virtually unknown. Gastroparesis seems to be important, independent of the presence or absence of diabetes. The association of actions to accelerate gastric emptying and to improve depressive feelings should be more effective than traditional treatment algorithms. The hypothesis is that the relief of dyspeptic symptoms would lead to better QOL and nutritional status.

### **Author details**

Paulo Roberto Santos1,2\*

Address all correspondence to: prsantos@fortalnet.com.br

1 Sobral Faculty of Medicine, Federal University of Ceará, Sobral, Brazil

2 Dialysis Unit, Santa Casa de Sobral Hospital, Sobral, Brazil
