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

Background Patients with end-stage renal disease (ESRD) and peptic ulcer disease (PUD) bleeding may be at high risk of bleeding complications. Objective To investigate the outcomes of patients with ESRD and PUD bleeding. Design ESRD patients with PUD bleeding were evaluated retrospectively. Setting Two tertiary, university-affiliated hospitals. Patients A 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 Measurements Rebleeding, transfusions, length of hospitalization, mortality. Results Multivariate 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). Limitation Retrospective study. Conclusion ESRD dialysis patients with PUD bleeding have greater rebleeding than patients not on dialysis. ESRD patients should be managed as a high-risk group.