Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis

Kuang Wei Huang, Hsin Bang Leu, Jiing Chyuan Luo, Wan Leong Chan, Ming Chih Hou, Han Chieh Lin, Fa Yauh Lee, Yi-Chun Kuan

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27 Citations (Scopus)

Abstract

Background: End stage renal disease (ESRD) patients receiving hemodialysis (HD) have a higher risk of peptic ulcer bleeding (PUB). Aims: Whether ESRD patients receiving peritoneal dialysis (PD) also carries a higher risk of PUB has not been studied. Methods: This was a cohort study using Taiwan's National Health Insurance research database, whereby 11,408 patients, including 2,239 PD, 2,328 HD, 2,267 chronic kidney disease (CKD) and 4,574 controls with age-sex matching were recruited. The log-rank test was used to analyze differences in accumulated PUB-free survival rates between groups. Cox proportional hazard regression was performed to evaluate independent risk factors for PUB in all the enrollees. Results: During the 7-year follow-up, PD and CKD patients had a significantly higher rate of PUB than matched controls. The risk of PUB between PD and CKD was not significantly different. Moreover, patients receiving HD carried a higher risk of PUB than those receiving PD, with CKD and controls (p all <0.05, by log-rank test). Cox proportional hazard regression analysis showed that CKD (HR 3.99, 95 % CI 2.24-7.13), PD (HR 3.71, 95 % CI 2.00-6.87) and HD (HR 11.96, 95 % CI 7.04-20.31) were independently associated with an increased risk of PUB. Being elderly, male, having hypertension, diabetes, cirrhosis, and nonsteroidal anti-inflammatory drugs and steroid use were other independent risk factors of PUB in all enrollees. Conclusions: Patients with CKD and ESRD receiving PD or HD carried a higher risk for PUB. They should be screened for risk factors for PUB and receive some protective measures to prevent PUB.

Original languageEnglish
Pages (from-to)807-813
Number of pages7
JournalDigestive Diseases and Sciences
Volume59
Issue number4
DOIs
Publication statusPublished - 2014

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Keywords

  • Chronic kidney disease (CKD)
  • End stage renal disease (ESRD)
  • Hemodialysis (HD)
  • Peptic ulcer bleeding (PUB)
  • Peritoneal dialysis (PD)

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

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