Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis

다국어 초록 (Multilingual Abstract)

Background: Compared to the general population, patients with end-stage renal disease have more gastrointestinal symptoms and a higher prevalence of peptic ulcer. Risk factors for peptic ulcer disease in patients with end-stage renal disease, however, remain poorly defined. This study aims to better identify those risk factors.
Methods: We analyzed 577 patients with end-stage renal disease from 2004 to 2016. We excluded patients with lifethreatening conditions. All patients underwent upper endoscopy. We analyzed patient medical records, medication history, and endoscopic findings. Independent sample t test, chi-square test, Fisher’s exact test, and multiple logistic regression analysis were used in statistical analyses.
Results: Of the 577 patients with end-stage renal disease, 174 had peptic ulcer disease (gastric or duodenal ulcer).
Patients on hemodialysis had a higher prevalence of peptic ulcer disease than those on peritoneal dialysis. Patients with peptic ulcer disease had lower serum albumin level and higher blood urea nitrogen level than those without peptic ulcer disease. Positive scores on two or more nutritional indices (albumin, serum cholesterol, uric acid, and creatinine levels) were associated with peptic ulcer disease in end-stage renal disease.
Conclusion: Hemodialysis, hypoalbuminemia, and multiple malnutrition indices were associated with the prevalence of peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

참고문헌 (Reference)

1 Jager KJ, "The effect of contraindications and patient preference on dialysis modality selection in ESRD patients in the Netherlands" 43 : 891-899, 2004

2 Park C, "Serum uric acid, protein intake and mortality in hemodialysis patients" 32 : 1750-1757, 2017

3 Park J, "Serum creatinine level, a surrogate of muscle mass, predicts mortality in peritoneal dialysis patients" 28 : 2146-2155, 2013

4 Kubo S, "Serum albumin and high-sensitivity C-reactive protein are independent risk factors of chronic kidney disease in middle-aged Japanese individuals : the circulatory risk in communities study" 23 : 1089-1098, 2016

5 Wasse H, "Risk factors for upper gastrointestinal bleeding among end-stage renal disease patients" 64 : 1455-1461, 2003

6 Tseng GY, "Recurrence of peptic ulcer in uraemic and non-uraemic patients after Helicobacter pylori eradication : a 2-year study" 26 : 925-933, 2007

7 Palmer BF, "Recent advances in the prevention and management of intradialytic hypotension" 19 : 8-11, 2008

8 Marques de Mattos A, "Protein oxidative stress and dyslipidemia in dialysis patients" 16 : 68-74, 2012

9 Sugimoto M, "Prevalence of Helicobacter pylori infection in long-term hemodialysis patients" 75 : 96-103, 2009

10 Liang CC, "Peptic ulcer disease risk in chronic kidney disease : ten-year incidence, ulcer location, and ulcerogenic effect of medications" 9 : e87952-, 2014

11 Kang JY, "Peptic ulcer and gastritis in uraemia, with particular reference to the effect of Helicobacter pylori infection" 14 : 771-778, 1999

12 Steiber A, "Multicenter study of the validity and reliability of subjective global assessment in the hemodialysis population" 17 : 336-342, 2007

13 Hakim RM, "Malnutrition in hemodialysis patients" 21 : 125-137, 1993

14 Walther CP, "Interdialytic creatinine change versus predialysis creatinine as indicators of nutritional status in maintenance hemodialysis" 27 : 771-776, 2012

15 Lopes AA, "Independent and joint associations of nutritional status indicators with mortality risk among chronic hemzodialysis patients in the Dialysis Outcomes and Practice Patterns Study(DOPPS)" 20 : 224-234, 2010

16 Luo JC, "Incidence of bleeding from gastroduodenal ulcers in patients with end-stage renal disease receiving hemodialysis" 183 : E1345-E1351, 2011

17 Iseki K, "Hypocholesterolemia is a significant predictor of death in a cohort of chronic hemodialysis patients" 61 : 1887-1893, 2002

18 Tseng GY, "Factors aside from Helicobacter pylori play an important role in the occurrence of peptic ulcer in dialysis patients" 75 : 1114-1115, 2009

19 Cuppari L, "Energy balance in advanced chronic kidney disease and end-stage renal disease" 23 : 373-377, 2010

20 Lee YC, "Different risk of common gastrointestinal disease between groups undergoing hemodialysis or peritoneal dialysis or with non-end stage renal disease: a nationwide population-based cohort study" 94 : e1482-, 2015

21 Chen YT, "Comparison of peptic ulcer disease risk between peritoneal and hemodialysis patients" 32 : 212-218, 2010

22 Hammer J, "Chronic gastrointestinal symptoms in hemodialysis patients" 110 : 287-291, 1998

23 Menon V, "C-reactive protein and albumin as predictors of all-cause and cardiovascular mortality in chronic kidney disease" 68 : 766-772, 2005

24 Moreau-Gaudry X, "A simple proteinenergy wasting score predicts survival in maintenance hemodialysis patients" 24 : 395-400, 2014

25 Fouque D, "A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease" 73 : 391-398, 2008