title: Is end stage renal disease a risk factor for the mortality of cirrhotic patients with esophageal variceal bleeding?
abstract: OBJECTIVE
  End stage renal disease (ESRD) patients are prone to have bleeding due to uremic platelet dysfunction. However, it is still unknown if ESRD is a risk factor for the mortality of cirrhotic patients with esophageal variceal bleeding (EVB).
  
  
  METHODS
  The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to enroll 6740 cirrhotic patients who were hospitalized with EVB from January 1 to December 31, 2007. The patients were matched with individuals from a national mortality database to calculate their survival time.
  
  
  RESULTS
  Of all, 418 patients had renal function impairment (RFI) during their hospitalization. There were 209 (50%) patients with acute renal failure (ARF), and 110 (26.3%) patients with ESRD. The adjusted hazard ratios (HR) of ARF for 6-week and 1-year mortalities of cirrhotic patients with EVB were 4.90 (P<0.001) and 4.34 (P<0.001), compared to the non-RFI group. However, the adjusted HRs of ESRD for 6-week and 1-year mortalities were 1.19 (P=0.404) and 1.50 (P<0.001), compared to the non-RFI impairment group.
  
  
  CONCLUSIONS
  ESRD is associated with 1-year mortality, but not a risk factor for 6-week mortality in cirrhotic patients with EVB.
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Hung
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Tseng
authors.forename: Kuo-Chih
authors.initials: KC
authors.lastname: Tseng
authors.forename: Yu-Hsi
authors.initials: YH
authors.lastname: Hsieh
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Tsai
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality*; D000328:Adult; D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors