Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease

Chang Seok Bang, Yong Seop Lee, Yun Hyeong Lee, Hotaik Sung, Hong Jun Park, Hyunsoo Kim, Jin Bong Kim, Gwang Ho Baik, Yeon Soo Kim, Jai Hoon Yoon, Dong Joon Kim, Ki Tae Suk

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

AIM: To evaluate the clinical characteristics of nonvariceal upper gastrointestinal hemorrhage (NGIH) in patients with chronic kidney disease (CKD). METHODS: From 2003 to 2010, a total of 72 CKD patients (male n = 52, 72.2%; female n = 20, 27.8%) who had undergone endoscopic treatments for NGIH were retrospectively identified. Clinical findings, endoscopic features, prognosis, rebleeding risk factors, and mortality-related factors were evaluated. The characteristics of the patients and rebleeding-related data were recorded for the following variables: gender, age, alcohol use and smoking history, past hemorrhage history, endoscopic findings (the cause, location, and size of the hemorrhage and the hemorrhagic state), therapeutic options for endoscopy, endoscopist experience, clinical outcomes, and mortality. RESULTS: The average size of the hemorrhagic site was 13.7 ± 10.2 mm, and the most common hemorrhagic site in the stomach was the antrum (n = 21, 43.8%). The most frequent method of hemostasis was combination therapy (n = 32, 44.4%). The incidence of rebleeding was 37.5% (n = 27), and 16.7% (n = 12) of patients expired due to hemorrhage. In a multivariate analysis of the risk factors for rebleeding, alcoholism (OR = 11.19, P = 0.02), the experience of endoscopists (OR = 0.56, P = 0.03), and combination endoscopic therapy (OR = 0.06, P = 0.01) compared with monotherapy were significantly related to rebleeding after endoscopic therapy. In a risk analysis of mortality after endoscopic therapy, only rebleeding was related to mortality (OR = 7.1, P = 0.02). CONCLUSION: Intensive combined endoscopic treatments by experienced endoscopists are necessary for the treatment of NGIH in patients with CKD, especially when a patient is an alcoholic.

Original languageEnglish
Pages (from-to)7719-7725
Number of pages7
JournalWorld Journal of Gastroenterology
Volume19
Issue number43
DOIs
Publication statusPublished - 2013 Nov 27

Fingerprint

Gastrointestinal Hemorrhage
Chronic Renal Insufficiency
Mortality
Therapeutics
Hemorrhage
Hemostasis
Alcoholism
Endoscopy
Stomach
Multivariate Analysis
Smoking
History
Alcohols
Incidence

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Bang, Chang Seok ; Lee, Yong Seop ; Lee, Yun Hyeong ; Sung, Hotaik ; Park, Hong Jun ; Kim, Hyunsoo ; Kim, Jin Bong ; Baik, Gwang Ho ; Kim, Yeon Soo ; Yoon, Jai Hoon ; Kim, Dong Joon ; Suk, Ki Tae. / Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease. In: World Journal of Gastroenterology. 2013 ; Vol. 19, No. 43. pp. 7719-7725.
@article{0c7d558be55e4685914a9951aa3c8283,
title = "Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease",
abstract = "AIM: To evaluate the clinical characteristics of nonvariceal upper gastrointestinal hemorrhage (NGIH) in patients with chronic kidney disease (CKD). METHODS: From 2003 to 2010, a total of 72 CKD patients (male n = 52, 72.2{\%}; female n = 20, 27.8{\%}) who had undergone endoscopic treatments for NGIH were retrospectively identified. Clinical findings, endoscopic features, prognosis, rebleeding risk factors, and mortality-related factors were evaluated. The characteristics of the patients and rebleeding-related data were recorded for the following variables: gender, age, alcohol use and smoking history, past hemorrhage history, endoscopic findings (the cause, location, and size of the hemorrhage and the hemorrhagic state), therapeutic options for endoscopy, endoscopist experience, clinical outcomes, and mortality. RESULTS: The average size of the hemorrhagic site was 13.7 ± 10.2 mm, and the most common hemorrhagic site in the stomach was the antrum (n = 21, 43.8{\%}). The most frequent method of hemostasis was combination therapy (n = 32, 44.4{\%}). The incidence of rebleeding was 37.5{\%} (n = 27), and 16.7{\%} (n = 12) of patients expired due to hemorrhage. In a multivariate analysis of the risk factors for rebleeding, alcoholism (OR = 11.19, P = 0.02), the experience of endoscopists (OR = 0.56, P = 0.03), and combination endoscopic therapy (OR = 0.06, P = 0.01) compared with monotherapy were significantly related to rebleeding after endoscopic therapy. In a risk analysis of mortality after endoscopic therapy, only rebleeding was related to mortality (OR = 7.1, P = 0.02). CONCLUSION: Intensive combined endoscopic treatments by experienced endoscopists are necessary for the treatment of NGIH in patients with CKD, especially when a patient is an alcoholic.",
author = "Bang, {Chang Seok} and Lee, {Yong Seop} and Lee, {Yun Hyeong} and Hotaik Sung and Park, {Hong Jun} and Hyunsoo Kim and Kim, {Jin Bong} and Baik, {Gwang Ho} and Kim, {Yeon Soo} and Yoon, {Jai Hoon} and Kim, {Dong Joon} and Suk, {Ki Tae}",
year = "2013",
month = "11",
day = "27",
doi = "10.3748/wjg.v19.i43.7719",
language = "English",
volume = "19",
pages = "7719--7725",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "43",

}

Bang, CS, Lee, YS, Lee, YH, Sung, H, Park, HJ, Kim, H, Kim, JB, Baik, GH, Kim, YS, Yoon, JH, Kim, DJ & Suk, KT 2013, 'Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease', World Journal of Gastroenterology, vol. 19, no. 43, pp. 7719-7725. https://doi.org/10.3748/wjg.v19.i43.7719

Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease. / Bang, Chang Seok; Lee, Yong Seop; Lee, Yun Hyeong; Sung, Hotaik; Park, Hong Jun; Kim, Hyunsoo; Kim, Jin Bong; Baik, Gwang Ho; Kim, Yeon Soo; Yoon, Jai Hoon; Kim, Dong Joon; Suk, Ki Tae.

In: World Journal of Gastroenterology, Vol. 19, No. 43, 27.11.2013, p. 7719-7725.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease

AU - Bang, Chang Seok

AU - Lee, Yong Seop

AU - Lee, Yun Hyeong

AU - Sung, Hotaik

AU - Park, Hong Jun

AU - Kim, Hyunsoo

AU - Kim, Jin Bong

AU - Baik, Gwang Ho

AU - Kim, Yeon Soo

AU - Yoon, Jai Hoon

AU - Kim, Dong Joon

AU - Suk, Ki Tae

PY - 2013/11/27

Y1 - 2013/11/27

N2 - AIM: To evaluate the clinical characteristics of nonvariceal upper gastrointestinal hemorrhage (NGIH) in patients with chronic kidney disease (CKD). METHODS: From 2003 to 2010, a total of 72 CKD patients (male n = 52, 72.2%; female n = 20, 27.8%) who had undergone endoscopic treatments for NGIH were retrospectively identified. Clinical findings, endoscopic features, prognosis, rebleeding risk factors, and mortality-related factors were evaluated. The characteristics of the patients and rebleeding-related data were recorded for the following variables: gender, age, alcohol use and smoking history, past hemorrhage history, endoscopic findings (the cause, location, and size of the hemorrhage and the hemorrhagic state), therapeutic options for endoscopy, endoscopist experience, clinical outcomes, and mortality. RESULTS: The average size of the hemorrhagic site was 13.7 ± 10.2 mm, and the most common hemorrhagic site in the stomach was the antrum (n = 21, 43.8%). The most frequent method of hemostasis was combination therapy (n = 32, 44.4%). The incidence of rebleeding was 37.5% (n = 27), and 16.7% (n = 12) of patients expired due to hemorrhage. In a multivariate analysis of the risk factors for rebleeding, alcoholism (OR = 11.19, P = 0.02), the experience of endoscopists (OR = 0.56, P = 0.03), and combination endoscopic therapy (OR = 0.06, P = 0.01) compared with monotherapy were significantly related to rebleeding after endoscopic therapy. In a risk analysis of mortality after endoscopic therapy, only rebleeding was related to mortality (OR = 7.1, P = 0.02). CONCLUSION: Intensive combined endoscopic treatments by experienced endoscopists are necessary for the treatment of NGIH in patients with CKD, especially when a patient is an alcoholic.

AB - AIM: To evaluate the clinical characteristics of nonvariceal upper gastrointestinal hemorrhage (NGIH) in patients with chronic kidney disease (CKD). METHODS: From 2003 to 2010, a total of 72 CKD patients (male n = 52, 72.2%; female n = 20, 27.8%) who had undergone endoscopic treatments for NGIH were retrospectively identified. Clinical findings, endoscopic features, prognosis, rebleeding risk factors, and mortality-related factors were evaluated. The characteristics of the patients and rebleeding-related data were recorded for the following variables: gender, age, alcohol use and smoking history, past hemorrhage history, endoscopic findings (the cause, location, and size of the hemorrhage and the hemorrhagic state), therapeutic options for endoscopy, endoscopist experience, clinical outcomes, and mortality. RESULTS: The average size of the hemorrhagic site was 13.7 ± 10.2 mm, and the most common hemorrhagic site in the stomach was the antrum (n = 21, 43.8%). The most frequent method of hemostasis was combination therapy (n = 32, 44.4%). The incidence of rebleeding was 37.5% (n = 27), and 16.7% (n = 12) of patients expired due to hemorrhage. In a multivariate analysis of the risk factors for rebleeding, alcoholism (OR = 11.19, P = 0.02), the experience of endoscopists (OR = 0.56, P = 0.03), and combination endoscopic therapy (OR = 0.06, P = 0.01) compared with monotherapy were significantly related to rebleeding after endoscopic therapy. In a risk analysis of mortality after endoscopic therapy, only rebleeding was related to mortality (OR = 7.1, P = 0.02). CONCLUSION: Intensive combined endoscopic treatments by experienced endoscopists are necessary for the treatment of NGIH in patients with CKD, especially when a patient is an alcoholic.

UR - http://www.scopus.com/inward/record.url?scp=84888110868&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888110868&partnerID=8YFLogxK

U2 - 10.3748/wjg.v19.i43.7719

DO - 10.3748/wjg.v19.i43.7719

M3 - Article

C2 - 24282360

AN - SCOPUS:84888110868

VL - 19

SP - 7719

EP - 7725

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 43

ER -