title: Different peptic ulcer bleeding risk in chronic kidney disease and end-stage renal disease patients receiving different dialysis.
abstract: BACKGROUND
  End stage renal disease (ESRD) patients receiving hemodialysis (HD) have a higher risk of peptic ulcer bleeding (PUB).
  
  
  OBJECTIVE
  Whether ESRD patients receiving peritoneal dialysis (PD) also carries a higher risk of PUB has not been studied.
  
  
  METHODS
  This was a cohort study using Taiwan's National Health Insurance research database, whereby 11,408 patients, including 2,239 PD, 2,328 HD, 2,267 chronic kidney disease (CKD) and 4,574 controls with age-sex matching were recruited. The log-rank test was used to analyze differences in accumulated PUB-free survival rates between groups. Cox proportional hazard regression was performed to evaluate independent risk factors for PUB in all the enrollees.
  
  
  RESULTS
  During the 7-year follow-up, PD and CKD patients had a significantly higher rate of PUB than matched controls. The risk of PUB between PD and CKD was not significantly different. Moreover, patients receiving HD carried a higher risk of PUB than those receiving PD, with CKD and controls (p all <0.05, by log-rank test). Cox proportional hazard regression analysis showed that CKD (HR 3.99, 95 % CI 2.24-7.13), PD (HR 3.71, 95 % CI 2.00-6.87) and HD (HR 11.96, 95 % CI 7.04-20.31) were independently associated with an increased risk of PUB. Being elderly, male, having hypertension, diabetes, cirrhosis, and nonsteroidal anti-inflammatory drugs and steroid use were other independent risk factors of PUB in all enrollees.
  
  
  CONCLUSIONS
  Patients with CKD and ESRD receiving PD or HD carried a higher risk for PUB. They should be screened for risk factors for PUB and receive some protective measures to prevent PUB.
authors: Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Kuang-Wei
authors: KW
authors: Huang
authors: Hsin-Bang
authors: HB
authors: Leu
authors: Jiing-Chyuan
authors: JC
authors: Luo
authors: Wan-Leong
authors: WL
authors: Chan
authors: Ming-Chih
authors: MC
authors: Hou
authors: Han-Chieh
authors: HC
authors: Lin
authors: Fa-Yauh
authors: FY
authors: Lee
authors: Yi-Chun
authors: YC
authors: Kuan
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003928:Diabetic Nephropathies / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology* / Q000517:prevention & control; D010530:Peritoneal Dialysis; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology