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

Research output: Contribution to journalArticle

24 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

Fingerprint

Peptic Ulcer
Chronic Renal Insufficiency
Chronic Kidney Failure
Dialysis
Hemorrhage
Peritoneal Dialysis
Renal Dialysis
National Health Programs
Taiwan
Fibrosis
Cohort Studies
Anti-Inflammatory Agents
Survival Rate
Steroids
Regression Analysis
Databases
Hypertension

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

Cite this

Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis. / Huang, Kuang Wei; Leu, Hsin Bang; Luo, Jiing Chyuan; Chan, Wan Leong; Hou, Ming Chih; Lin, Han Chieh; Lee, Fa Yauh; Kuan, Yi-Chun.

In: Digestive Diseases and Sciences, Vol. 59, No. 4, 2014, p. 807-813.

Research output: Contribution to journalArticle

Huang, Kuang Wei ; Leu, Hsin Bang ; Luo, Jiing Chyuan ; Chan, Wan Leong ; Hou, Ming Chih ; Lin, Han Chieh ; Lee, Fa Yauh ; Kuan, Yi-Chun. / Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis. In: Digestive Diseases and Sciences. 2014 ; Vol. 59, No. 4. pp. 807-813.
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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.",
keywords = "Chronic kidney disease (CKD), End stage renal disease (ESRD), Hemodialysis (HD), Peptic ulcer bleeding (PUB), Peritoneal dialysis (PD)",
author = "Huang, {Kuang Wei} and Leu, {Hsin Bang} and Luo, {Jiing Chyuan} and Chan, {Wan Leong} and Hou, {Ming Chih} and Lin, {Han Chieh} and Lee, {Fa Yauh} and Yi-Chun Kuan",
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T1 - Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis

AU - Huang, Kuang Wei

AU - Leu, Hsin Bang

AU - Luo, Jiing Chyuan

AU - Chan, Wan Leong

AU - Hou, Ming Chih

AU - Lin, Han Chieh

AU - Lee, Fa Yauh

AU - Kuan, Yi-Chun

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Chronic kidney disease (CKD)

KW - End stage renal disease (ESRD)

KW - Hemodialysis (HD)

KW - Peptic ulcer bleeding (PUB)

KW - Peritoneal dialysis (PD)

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