Özgür Can1, Gözde Koç2, Sema Berk Ocak3, Nursel Akbay4, Emel Ahishali5, Mustafa Canbakan2, Gülizar Manga Şahin2, Süheyla Apaydin6. 1. Department of Nephrology, Haydarpaşa Numune Training and Research Hospital, Tıbbiye Cad. No: 40 Üsküdar, 34668, Istanbul, Turkey. canozgur62@hotmail.com. 2. Department of Nephrology, Haydarpaşa Numune Training and Research Hospital, Tıbbiye Cad. No: 40 Üsküdar, 34668, Istanbul, Turkey. 3. Department of General Surgery, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. 4. Department of Internal Medicine, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. 5. Department of Gastroenterology, Dr. Kartal Lutfi Kırdar Training and Research Hospital, Istanbul, Turkey. 6. Department of Nephrology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Abstract
PURPOSE: Gastrointestinal bleeding remains the leading cause of morbidity and mortality for patients who need hemodialysis treatment. Our aim was to evaluate patients who needed hemodialysis and presented with bleeding during their hospital stay (uremic bleeding patients). Factors that increased the risk of bleeding and death were evaluated. Additionally, uremic bleeding patients were compared to non-uremic bleeding patients regarding gastrointestinal findings. PATIENTS AND METHODS: Fifty-one uremic bleeding patients were compared to two control groups which included uremic (hemodialysis dependent and non-bleeding) and non-uremic (no renal insufficiency and bleeding) patients. RESULTS: NSAIDs and anti-ulcer drug usage were more common in uremic bleeding and in uremic non-bleeding groups, respectively. Dialysis vintage was longer in uremic bleeding group. Comparison of uremic bleeding and non-bleeding uremic patients regarding the usage of ACEI or ARB drugs yielded non-significant results. Acute kidney injury, lower plasma albumin level and high CRP level were significantly increased the risk of mortality in uremic bleeding patients. Hospital stay more than 1 week was the only strong factor for mortality when multivariate analysis was performed. Gastroduodenal and duodenal ulcers were significantly detected in uremic bleeding and non-uremic bleeding patients; respectively. CONCLUSIONS: Hemodialysis patients presenting with gastrointestinal bleeding should be evaluated regarding use of prescriptions and efforts should be done in order to shorten their hospital stay and decrease their mortality. Effect of ACEI or ARB drugs should also be evaluated in future studies.
PURPOSE:Gastrointestinal bleeding remains the leading cause of morbidity and mortality for patients who need hemodialysis treatment. Our aim was to evaluate patients who needed hemodialysis and presented with bleeding during their hospital stay (uremic bleedingpatients). Factors that increased the risk of bleeding and death were evaluated. Additionally, uremic bleedingpatients were compared to non-uremic bleedingpatients regarding gastrointestinal findings. PATIENTS AND METHODS: Fifty-one uremic bleedingpatients were compared to two control groups which included uremic (hemodialysis dependent and non-bleeding) and non-uremic (no renal insufficiency and bleeding) patients. RESULTS: NSAIDs and anti-ulcer drug usage were more common in uremic bleeding and in uremic non-bleeding groups, respectively. Dialysis vintage was longer in uremic bleeding group. Comparison of uremic bleeding and non-bleeding uremicpatients regarding the usage of ACEI or ARB drugs yielded non-significant results. Acute kidney injury, lower plasma albumin level and high CRP level were significantly increased the risk of mortality in uremic bleedingpatients. Hospital stay more than 1 week was the only strong factor for mortality when multivariate analysis was performed. Gastroduodenal and duodenal ulcers were significantly detected in uremic bleeding and non-uremic bleedingpatients; respectively. CONCLUSIONS: Hemodialysis patients presenting with gastrointestinal bleeding should be evaluated regarding use of prescriptions and efforts should be done in order to shorten their hospital stay and decrease their mortality. Effect of ACEI or ARB drugs should also be evaluated in future studies.
Authors: F K Chan; S C Chung; B Y Suen; Y T Lee; W K Leung; V K Leung; J C Wu; J Y Lau; Y Hui; M S Lai; H L Chan; J J Sung Journal: N Engl J Med Date: 2001-03-29 Impact factor: 91.245
Authors: Hyun Lim; Jong Hyeok Kim; Gwang Ho Baik; Ji Won Park; Ho Suk Kang; Sung Hoon Moon; Choong Kee Park Journal: J Gastroenterol Hepatol Date: 2015-03 Impact factor: 4.029