Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease - 22/08/11
Reprint requests: Justin Cheung, MD, FRCPC, Gastroenterology, Zeidler Ledcor Centre, 130 University Campus, Edmonton, Alberta, Canada T6G 2X8.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.
Le texte complet de cet article est disponible en PDF.Abbreviations : CKD, Cr, ESRD, OR, PPI, PUD, UGIB
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| See CME section; p. 139 |
Vol 71 - N° 1
P. 44-49 - janvier 2010 Retour au numéro
Article précédent
- Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy
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- GI bleeding risk in patients undergoing dialysis
- Anitha B. Toke
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