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Gastrointestinal bleeding in patients with renal failure under hemodialysis treatment: a single-center experience

  • Nephrology - Original Paper
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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.

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Authors and Affiliations

  1. Department of Nephrology, Haydarpaşa Numune Training and Research Hospital, Tıbbiye Cad. No: 40 Üsküdar, 34668, Istanbul, Turkey

    Özgür Can, Gözde Koç, Mustafa Canbakan & Gülizar Manga Şahin

  2. Department of General Surgery, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey

    Sema Berk Ocak

  3. Department of Internal Medicine, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey

    Nursel Akbay

  4. Department of Gastroenterology, Dr. Kartal Lutfi Kırdar Training and Research Hospital, Istanbul, Turkey

    Emel Ahishali

  5. Department of Nephrology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Süheyla Apaydin

Authors
  1. Özgür Can
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  2. Gözde Koç
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  3. Sema Berk Ocak
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  4. Nursel Akbay
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  5. Emel Ahishali
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  6. Mustafa Canbakan
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  7. Gülizar Manga Şahin
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  8. Süheyla Apaydin
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Correspondence to Özgür Can.

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We have no conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Second Hospital of Jilin University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Can, Ö., Koç, G., Ocak, S.B. et al. Gastrointestinal bleeding in patients with renal failure under hemodialysis treatment: a single-center experience. Int Urol Nephrol 49, 889–894 (2017). https://doi.org/10.1007/s11255-017-1517-y

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  • DOI: https://doi.org/10.1007/s11255-017-1517-y

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