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Gastrointest Endosc. 2010 Jan;71(1):44-9. doi: 10.1016/j.gie.2009.04.014.

Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease.

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  • 1Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

Patients with end-stage renal disease (ESRD) and peptic ulcer disease (PUD) bleeding may be at high risk of bleeding complications.

OBJECTIVE:

To investigate the outcomes of patients with ESRD and PUD bleeding.

DESIGN:

ESRD patients with PUD bleeding were evaluated retrospectively.

SETTING:

Two tertiary, university-affiliated hospitals.

PATIENTS:

A total of 150 PUD bleeding patients were evaluated in 3 groups; end-stage renal disease (ESRD) patients on dialysis (ESRD group) (n = 50) were age matched with patients with chronic kidney disease (CKD) not requiring dialysis (CKD group) (n = 50) and those with normal kidney function (normal group) (n = 50).

MAIN OUTCOME MEASUREMENTS:

Rebleeding, transfusions, length of hospitalization, mortality.

RESULTS:

Multivariate analysis showed significant predictors of rebleeding to be ESRD and high-risk stigmata. The ESRD group had an odds ratio (OR) of 3.8 (95% CI, 1.4-10.5; P = .008) for rebleeding compared with the normal group, and an OR of 3.8 (95% CI, 1.4-10.3; P = .01) compared with the CKD group. The mean number of (+/- SD) transfusions was higher in the ESRD group (6.3 +/- 5.7 units) than in the normal group (3.6 +/- 3.9 units; P = .01). The mean length of hospitalization was higher in the ESRD group than in the normal group (34.0 vs 16.6 days; P = .01). A greater level of comorbidity was the only significant predictor of mortality (OR 6.0; 95% CI, 2.9-12.3; P = .001).

LIMITATION:

Retrospective study.

CONCLUSION:

ESRD dialysis patients with PUD bleeding have greater rebleeding than patients not on dialysis. ESRD patients should be managed as a high-risk group.

2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

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PMID:
19595311
[PubMed - indexed for MEDLINE]
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