Risk factors for peptic ulcer in patients with chronic kidney disease = 만성 신부전 환자에서의 소화성 궤양 질환 발생의 위험 인자

다국어 초록 (Multilingual Abstract)

Background : Comparison to the general population, patients with chronic kidney disease (CKD) are suffering from more gastrointestinal symptom. Also, among the most important prognostic factors in these patients, especially peptic ulcer bleeding is considered as a critical issue. There have been some studies about the risk factors and mortality in dialysis patients with peptic ulcer bleeding, but there are few data concerning the risk factors of peptic ulcer in chronic kidney disease.
Methods: We retrospectively analyzed the records of 742 patients diagnosed as chronic kidney disease (eGFR <60mL/min) in the Chonnam National University of Hospital, which was defined as estimated glomerular filtration rate (eGFR) less than 60mL/min/1.73m2. All patients underwent the upper endoscopy. We analyzed medical records, medication history, endoscopic findings. In this study, we excluded the patients with active peptic ulcer bleeding. Subgroup analysis was executed by the two classification system; the ulcer location and the dialysis or not.
Results: Among 742 patients, 212 patients(28%) had peptic ulcer (either gastric ulcer or duodenal ulcer). Peptic ulcer occurred more frequently in the elderly(Age>70) and male gender. Patients with peptic ulcer are shown to have an advanced CKD stages (lower glomerular filtration rate, p=0.002). Through the multivariate analysis of risk factors, male gender, lower systolic blood pressure, low albumin levels (albumin <3.5g/dL) were significant risk factors foe peptic ulcer in the patients withCKD (p<0.001). Subgroup analysis by the dialysis dependency, low albumin level was associated with peptic ulcer in the dialytic-CKD patients. Among the non-dialytic CKD patients, low albumin level was not associated with peptic ulcer, low ALP level is thought to be the risk factor.
Conclusions: Among the patients with the dialytic-CKD, low albumin level, male gender and low systolic blood pressure are associated with peptic ulcer. Whereas, low ALP level and low systolic pressure were associated with peptic ulcer in non-dialytic CKD patients.

목차 (Table of Contents)

• Abstract 1
• Introduction3
• Subjects and Methods.4
• Results6
• Discussion8
• References12
• Abstract (Korean)14