Gastrointestinal hemorrhage in hemodialysis patients.
BACKGROUND
Gastrointestinal bleedings are frequently dramatic events. So far hardly any data concerning the frequency of such bleedings in patients treated with chronic hemodialysis are available. Thus, the objective of this study is to collect data about the incidence of such events in a dialysis center.


METHODS
Data of a total of 65 patients who had been treated in the dialysis center between January 01, 2000 and February 28, 2007, including all episodes of gastrointestinal bleedings, have been collected and a correlation with the duration of treatment with hemodialysis has been established. Afterwards we differentiated between those patients who additionally were treated with anticoagulants and those who were not.


RESULTS
In a total of 3195 months of treatment, 11 gastrointestinal bleedings were observed. In patients who underwent anticoagulation therapy the risk of experiencing gastrointestinal bleeding was approximately 3 times higher (one episode of bleeding in 16 years) than in the other patients (one episode of bleeding in 46.2 years).


CONCLUSIONS
Compared to the general population, the incidence of gastrointestinal bleeding is increased in hemodialysis patients. Treatment with anticoagulants leads to an even higher risk. Consequently, with regard to concomitant medication which might contribute to increasing the risk of gastrointestinal bleeding, the necessity and therapeutic benefits of the treatment have to be carefully weighed against the potential risks that it might carry for the individual patient.
Furkert
J D
JD
Nephrology and Gastroenterology, SLK-Kliniken Heilbronn, Bad Friedrichshall. juergen.furkert@slk-kliniken.de
Zeier
M
M
Schwenger
V
V
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors
D000925:Anticoagulants