Angiodysplasia in Renal Disease Patients: Analysis of Risk Factors and Approach to Manage Such Patients

Abstract

Gastrointestinal bleeding due to angiodysplasia is a common problem in patients with renal insufficiency. There are several theories to explain the increased occurrence of these lesions in this specific group of patients, including various metabolic factors and existence of comorbidities. Advancements made in diagnostic measures have helped route the approach in patients with different risk factors and have also helped solve the dual purpose involving therapeutic intervention with endoscopy. We conducted a thorough literature search on PubMed to extract relevant data. A total of 29 articles were chosen after applying the inclusion and exclusion criteria. Although the clinical presentations may vary in this cohort of patients, and bleeding is known to stop spontaneously, a conservative approach may not be enough. Endoscopic treatment, use of hormones like estrogen, octreotide, and vasopressin, arterial embolization, and lastly surgery are valuable therapeutic tools.

Diagnostic evaluation and assessment of anemia in a patient with chronic kidney disease and gastrointestinal angioectasias undergoing hemodialysis

“…In this case, angioectasias were successfully treated with thermo‐coagulation with argon plasma. Studies show that for angioectasia‐related gastrointestinal bleeding, therapeutic options include endoscopic therapy (i.e., laser photoablation, thermo‐coagulation with argon plasma, and bi‐ or multipolar electrocoagulation), certain drugs as octeotride (not available at that time), thalidomide or conjugated estrogen; and surgery 7,8 . Angioectasias locations were key determining treatment effectiveness.…”