Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Suzuki, Hiromichi

doi:10.15406/unoaj.2015.02.00021

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…14 Yorioka et al, 15 reported on a patient with end-stage renal disease (ESRD) and bleeding from watermelon stomach (gastric antral vascular ectasia) who improved after the dialysis modality was changed from HD to CAPD. However, other reports exist of watermelon stomach and bleeding in CAPD patients 16,17 which may counter the suggestion of haemostatic risk factors, except uremic toxins, contributing to the occurrence of watermelon stomach in CAPD patients. In the present study, two CAPD patients with upper GI bleeding and one CAPD patient with lower GI bleeding were diagnosed as having gastric antral vascular ectasia.…”

Section: Discussionmentioning

confidence: 92%

Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Suzuki¹

2015

UNOAJ

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Background and study aims: Dialysis patients can develop a number of gastrointestinal (GI) lesions that can result in bleeding in emergency situations. Our aim was to investigate the nature of GI bleeding that needed emergency endoscopy. Patients and Methods: Over a 5-year period (April 1, 2007-March 31, 2012, we studied consecutive dialysis patients with GI bleeding who underwent emergency endoscopic procedures. Demographic and clinical data were also collected.Results: Fifty-two patients were hospitalized for emergency GI bleeding and underwent a subsequent endoscopy. The locations of lesions involved in GI bleeding were: upper GI (n=34), lower GI (n=14), and unknown (n=4). Duodenal ulcer (26%) and gastric antral vascular ectasia (26%) were the most frequently identified causes of upper GI bleeding, followed by gastric ulcer (14%). In patients with lower GI bleeding, colorectal cancer, angiodysplasia and ischemic enteritis were identified in equal numbers (21%). Two thirds of patients with gastric antral vascular ectasia had recurrence in spite of treatment by argon plasma coagulation. Conclusion:The causes of GI bleeding in dialysis patients in emergency situations may differ from those in non-dialysis patients with GI bleeding.

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Section: Discussionmentioning

confidence: 92%

Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Suzuki¹

2015

UNOAJ

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Section: Causes Of Ugi Bleedingmentioning

confidence: 99%

“…In ESRD patients, the estimated frequency is 21 bleeds per 1,000 patient years with a very high risk of mortality accounting for 3-7% of all deaths (7,8,32,33). Disordered hemostasis of uremia resulting from platelet and endothelial dysfunction, associated anemia, secondary hyperparathyroidism and the use of medications that likely affect the clotting cascade (e.g., clopidogrel, aspirin, and other NSAIDs) are considered risk factors for UGI bleeding (2,9,32,34).…”

Section: Upper Gastrointestinal Bleedingmentioning

confidence: 99%

“…Higher rate of angiodysplasia was shown in patients on hemodialysis than in those on peritoneal dialysis (7). Gastric antral vascular ectasia was documented as the most common cause of UGI bleeding as well as recurrent bleeding in patients who received dialysis therapy during emergencies, followed by gastroduodenal ulcer disease (34,39). However, angiodysplasia has also been indicated to occur at a much lower incidence when considered as a cause of UGI bleeding in patients with ESRD, with incidence similar to the general population (7).…”

Section: Causes Of Ugi Bleedingmentioning

confidence: 99%

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Diyaliz Hastalarnda Üst Gastrointestinal Sistem Hastalıkları

Kızıltaş¹

2020

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The prevalence of co-morbid gastrointestinal symptoms is high in dialysis patients, and dyspeptic symptoms, such as nausea, vomiting, and epigastric burning are the most common symptoms. Upper gastrointestinal disorders (e.g., peptic ulcer disease and gastroparesis) underlie most of these symptoms, while less common but severe complications are also likely that include gastrointestinal bleeding from gastric antral vascular ectasia, erosions or ulcers. Incidence of gastrointestinal disorders is considered to increase with the duration of renal failure, independent of dialysis modality. While uremia and dialysis have been linked to an increased risk of gastrointestinal tract lesions, pathogenesis of gastrointestinal dysfunction in end-stage renal disease is considered to be multifactorial and has not yet been clarified. In addition, conflicting data exist on the association of renal dysfunction with gastrointestinal disorders, and there are no explicit guidelines for the management of co-morbid gastrointestinal problems in patients with concomitant renal failure. Herein, we review the common upper gastrointestinal disorders that occur among dialysis patients, with an emphasis on prevalence, pathogenesis and diagnostic strategies.

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Upper gastrointestinal bleeding in patients with end stage renal disease: causes, characteristics and factors associated with need for endoscopic therapeutic intervention

Laeeq

Tasneem

Hanif

et al. 2017

Journal of Translational Internal Medicine

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Background and Objectives: The risk of upper gastrointestinal bleeding (UGIB) is increased among the end-stage renal disease (ESRD) patients. The aim of the current study was to describe the causes and characteristics of UGIB in ESRD patients at our center and to assess the need for endoscopic therapeutic intervention (ETI) using Rockall (RS) and Glasgow Blatchford scores (GBS). Material and Methods: All patients with ESRD and UGIB with age ≥14 years were included. Frequencies and percentages were computed for categorical variables. Chi square test or Fischer's exact test was used for statistical analysis. Results: A total of 59 subjects had a mean age of 47.25 ± 15 years.The most common endoscopic findings seen were erosions in 33 (55.9%) patients, followed by ulcers in 18 (30.3%) patients. ETI was required in 33 (55.9%) patients, which included adrenaline injection in 19 (32.3%), hemoclip in 9 (15.2%) and argon plasma coagulation in 5 (8.4%) patients. Factors associated with the need of ETI were identified as: a combined presentation of hematemesis and melena (P=0.033), ulcer (P=0.002) and associated chronic liver disease (P=0.015). Six (10.1%) patients died. Death was more common if ETI was not performed (P=0.018). Conclusion: ETI was more commonly required in patients on maintenance hemodialysis with UGIB, who had presence of combined hematemesis and melena, ulcers and associated chronic liver disease. A Glasgow Blatchford score of >14 was helpful in assessing the need for ETI in these patients.

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Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Cited by 3 publications

References 23 publications

Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Diyaliz Hastalarnda Üst Gastrointestinal Sistem Hastalıkları

Upper gastrointestinal bleeding in patients with end stage renal disease: causes, characteristics and factors associated with need for endoscopic therapeutic intervention

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