Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease

BackgroundPatients with end-stage renal disease (ESRD) and peptic ulcer disease (PUD) bleeding may be at high risk of bleeding complications.ObjectiveTo investigate the outcomes of patients with ESRD and PUD bleeding.DesignESRD patients with PUD bleeding were evaluated retrospectively.SettingTwo tertiary, university-affiliated hospitals.PatientsA total of 150 PUD bleeding patients were evaluated in 3 groups; end-stage renal disease (ESRD) patients on dialysis (ESRD group) (n = 50) were age matched with patients with chronic kidney disease (CKD) not requiring dialysis (CKD group) (n = 50) and those with normal kidney function (normal group) (n = 50).Main Outcome MeasurementsRebleeding, transfusions, length of hospitalization, mortality.ResultsMultivariate analysis showed significant predictors of rebleeding to be ESRD and high-risk stigmata. The ESRD group had an odds ratio (OR) of 3.8 (95% CI, 1.4-10.5; P = .008) for rebleeding compared with the normal group, and an OR of 3.8 (95% CI, 1.4-10.3; P = .01) compared with the CKD group. The mean number of (± SD) transfusions was higher in the ESRD group (6.3 ± 5.7 units) than in the normal group (3.6 ± 3.9 units; P = .01). The mean length of hospitalization was higher in the ESRD group than in the normal group (34.0 vs 16.6 days; P = .01). A greater level of comorbidity was the only significant predictor of mortality (OR 6.0; 95% CI, 2.9-12.3; P = .001).LimitationRetrospective study.ConclusionESRD dialysis patients with PUD bleeding have greater rebleeding than patients not on dialysis. ESRD patients should be managed as a high-risk group.