Investigation of gastrointestinal bleeding in patients with end stage renal disease.

In order to evaluate the source and course of gastrointestinal bleeding in patients with established renal insufficiency, we reviewed data on 40 patients with renal failure and gastrointestinal bleeding seen over 2 yr. A randomly selected control group of 39 patients without renal failure was used for comparison. Medical records of our University Hospital were reviewed, and patients with a documented gastrointestinal bleed and renal insufficiency (creatinine greater than 1.7 mg/dl) were included in this study. Panendoscopy was the most valuable procedure in terms of establishing a diagnosis as to the cause of bleeding. Colonoscopy was of questionable value unless the bleed was clearly of lower intestinal origin. Recurrent bleeding during the index admission occurred with the same frequency in both groups of patients. Both groups used nonsteroidal anti-inflammatory agents frequently. The findings and outcome for this group of patients with renal failure was comparable to the control patients with gastrointestinal bleeding.