Comparison of Peptic Ulcer Disease Risk between Peritoneal and Hemodialysis Patients

Chen, Yung Tai; Wu, Yang; Lin, Chih Ching; Ng, Yee Yung; Chen, Jinn Yang; Li, Szu Yuan

doi:10.1159/000316963

Cited by 19 publications

(18 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The SHR of eGFR was similar in univariate (0.89) and multivariate (0.90) competing-risks regressions, suggesting that eGFR is the main effect variable. The association between lower serum albumin values and higher UGIB risk is also supported by a previous study in patients with CKD receiving dialysis (19). A history of UGIB is an important risk factor but has not been taken into consideration in previous studies (1)(2)(3)6,(20)(21)(22).…”

Section: Discussionmentioning

confidence: 81%

Upper Gastrointestinal Bleeding in Patients with CKD

Liang

Wang

Kuo

et al. 2014

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives Patients with CKD receiving maintenance dialysis are at risk for upper gastrointestinal bleeding. However, the risk of upper gastrointestinal bleeding in patients with early CKD who are not receiving dialysis is unknown. The hypothesis was that their risk of upper gastrointestinal bleeding is negatively linked to renal function. To test this hypothesis, the association between eGFR and risk of upper gastrointestinal bleeding in patients with stages 3-5 CKD who were not receiving dialysis was analyzed. Results In total, 2968 patients with stages 3-5 CKD who were not receiving dialysis were followed for a median of 1.9 years. The incidence of upper gastrointestinal bleeding per 100 patient-years was 3.7 (95% confidence interval, 3.5 to 3.9) in patients with stage 3 CKD, 5.0 (95% confidence interval, 4.8 to 5.3) in patients with stage 4 CKD, and 13.9 (95% confidence interval, 13.1 to 14.8) in patients with stage 5 CKD. Higher eGFR was associated with a lower risk of upper gastrointestinal bleeding (P=0.03), with a subdistribution hazard ratio of 0.93 (95% confidence interval, 0.87 to 0.99) for every 5 ml/min per 1.73 m 2 higher eGFR. A history of upper gastrointestinal bleeding (P,0.001) and lower serum albumin (P=0.004) were independently associated with higher upper gastrointestinal bleeding risk. ConclusionsIn patients with CKD who are not receiving dialysis, lower renal function is associated with higher risk for upper gastrointestinal bleeding. The risk is higher in patients with previous upper gastrointestinal bleeding history and low serum albumin.

show abstract

Section: Discussionmentioning

confidence: 81%

Upper Gastrointestinal Bleeding in Patients with CKD

Liang

Wang

Kuo

et al. 2014

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Anticoagulant use during HD may contribute to this risk [3]–[6], [10]–[12]. In addition, intradialytic hypotension and hemodynamic changes might play a role in the occurrence of PUD.…”

Section: Discussionmentioning

confidence: 99%

“…Both PUD and CKD are leading public-health issues [8], [9], and many studies have described associations between them [2]–[7], [10], [11]. Despite this, limited information is available about temporal trends in PUD among CKD patients [5], [11].…”

Section: Introductionmentioning

confidence: 99%

Peptic Ulcer Disease Risk in Chronic Kidney Disease: Ten-Year Incidence, Ulcer Location, and Ulcerogenic Effect of Medications

et al. 2014

View full text Add to dashboard Cite

ObjectivesWe aimed at determining peptic ulcer disease (PUD) incidence among chronic kidney disease (CKD) patients during 1998–2008, compared to patients without CKD, and at examining associations between CKD and PUD.MethodsData for 1998–2008 were extracted from the National Health Insurance Research Database in Taiwan. The annual PUD incidence (cases per thousand persons per year) was calculated separately for patients with and without CKD. Characteristics of patients with newly diagnosed PUD (n = 16322) were compared to those of a control group without PUD (n = 32644). The 2 groups were matched for age, sex, and index year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression.ResultsOver the 10-year period, the PUD incidence was ∼10–12 times higher in CKD patients than in those without CKD. Its incidence in elderly CKD patients increased rapidly over time. For CKD patients, most PUD events (>95%) were managed during hospitalization. Peptic ulcer risk, adjusted for all potential confounders, was much higher in CKD patients undergoing hemodialysis (adjusted OR, 9.74; 95% CI, 7.11–13.31). Maintenance hemodialysis patients were 2 times more likely to have gastric ulcers than duodenal ulcers, while CKD patients not on dialysis had similar risks for both. There were no significant interactions between medications and CKD status on the peptic ulcer risk. Unlike CKD patients on nonsteroidal anti-inflammatory drugs and clopidogrel, those on aspirin did not have a higher peptic ulcer risk (adjusted OR, 0.88; 95% CI, 0.44–1.77).ConclusionsCKD patients have a substantially increased PUD risk, and the majority of CKD patients with PUD require hospital management. Further, peptic ulcer risk is affected by hemodialysis therapy, patient status (inpatient vs. outpatient), and ulcerogenic medications.

show abstract

“…The risk factors for peptic ulcers in dialysis patients are age, PD, diabetes mellitus, congestive heart failure, low serum albumin and high gamma-glutamyl transpeptidase levels [28].…”

Section: H Pylori Infection and Peptic Ulcersmentioning

confidence: 99%

Gastrointestinal Disorders in Peritoneal Dialysis Patients

et al. 2018

View full text Add to dashboard Cite

Background: Gastrointestinal (GI) disorders in peritoneal dialysis (PD) patients are relatively understudied in the literature, even though they have a serious impact in the morbidity parameters and the quality of life for this group of patients. Various diagnostic tools have been used, including instrumental methods and questionnaires, invariably validated in comparative studies. Summary: The prevalence of GI disorders is very high in PD patients. Compared to the haemodialysis patients they present a higher prevalence of reflux, eating dysfunction, gastroesophageal reflux, intestinal obstruction or adhesions and abdominal hernia. They may be divided into Gastric disorders (Gastroesophageal reflux disease, pathological Gastric emptying, Dyspepsia, Helicobacter pylori infection, peptic ulcers) and Intestinal disorders (Peritonitis, Diverticulosis, Constipation). Key Messages: The current paper is a review of the literature involving GI disorders in PD patients. This special group of patients with a special role of the peritoneal cavity and the GI motility in the physiology of their dialysis merit a larger number of studies dealing with the interrelation of the GI tract and the PD physiological, functional and pathophysiological parameters.

show abstract

Comparison of Peptic Ulcer Disease Risk between Peritoneal and Hemodialysis Patients

Cited by 19 publications

References 52 publications

Upper Gastrointestinal Bleeding in Patients with CKD

Upper Gastrointestinal Bleeding in Patients with CKD

Peptic Ulcer Disease Risk in Chronic Kidney Disease: Ten-Year Incidence, Ulcer Location, and Ulcerogenic Effect of Medications

Gastrointestinal Disorders in Peritoneal Dialysis Patients

Contact Info

Product

Resources

About