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KMID : 0882420070720060616
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Korean Journal of Medicine
2007 Volume.72 No. 6 p.616 ~ p.624
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Risk factors of gastrointestinal bleeding for end-stage renal disease patients
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Oh Hyung-Jung
Kim Seung-Jun
Park Sun-Young
Yoo Dong-Eun
Lee Han-Sung
Ku Nam-Su
Moon Ji-Ae
Kim Dong-Kie
Lee Tae-Hee
Moon Sung-Jin
Han Seung-Hyeok
Lee Jung-Eun
Choi Hoon-Young
Han Dae-Suk
Kang Shin-Wook
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Abstract
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Backgroudn:Gastrointestinal bleeding (GIB) is not a rare complication in end-stage renal disease (ESRD) patients on dialysis and the occurrence of GIB has also been associated with higher morbidity and mortality rates. However, reasons for the high incidence of GIB are not clear. This retrospective study was undertaken not only to analyze the clinical features of GIB but also to elucidate the independent risk factors for GIB in Korean ESRD patients.
Methods:One hundred thirty ESRD patients on dialysis at the Severance Hospital of Yonsei University College of Medicine from January 2000 to December 2005 were included in the study. The patients were divided into two groups: 65 patients with GIB (the GIB group) and 65 age-, sex-, and dialysis modality-matched patients without GIB (the C group). Clinical characteristics, medications, and laboratory findings were compared between the two groups.
Results:Compared to the C group, congestive heart failure (40.0% vs. 21.5%, p<0.05), coronary arterial occlusive disease (CAOD) (32.3% vs. 4.6%, p<0.005), and nonsteroidal anti-inflammatory drug (NSAID) use (18.4% vs. 1.5%, p<0.01) were significantly more common in the GIB group. The baseline serum albumin levels were significantly lower in the GIB group than in the C group (2.53+/-0.67 g/dL vs. 3.56+/-0.63 g/dL, p<0.005). Using logistic regression analysis, CAOD (OR=23.0), NSAID use (OR=12.5), and lower serum albumin levels (OR=2.9) were identified as independent risk factors for GIB (p<0.05).
Conclusions:Careful attention must be paid to ESRD patients with CAOD, taking NSAIDs, or with low serum albumin levels in view of GIB.
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KEYWORD
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End-stage renal disease, Gastrointestinal bleeding, Coronary arterial occlusive disease, Nonsteroidal anti-inflammatory drug, Serum albumin
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