Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis

Abstract

Background: Compared to the general population, patients with end-stage renal disease have more gastrointestinal symptoms and a higher prevalence of peptic ulcer. Risk factors for peptic ulcer disease in patients with end-stage renal disease, however, remain poorly defined. This study aims to better identify those risk factors.

Methods: We analyzed 577 patients with end-stage renal disease from 2004 to 2016. We excluded patients with life-threatening conditions. All patients underwent upper endoscopy. We analyzed patient medical records, medication history, and endoscopic findings. Independent sample t test, chi-square test, Fisher's exact test, and multiple logistic regression analysis were used in statistical analyses.

Results: Of the 577 patients with end-stage renal disease, 174 had peptic ulcer disease (gastric or duodenal ulcer). Patients on hemodialysis had a higher prevalence of peptic ulcer disease than those on peritoneal dialysis. Patients with peptic ulcer disease had lower serum albumin level and higher blood urea nitrogen level than those without peptic ulcer disease. Positive scores on two or more nutritional indices (albumin, serum cholesterol, uric acid, and creatinine levels) were associated with peptic ulcer disease in end-stage renal disease.

Conclusion: Hemodialysis, hypoalbuminemia, and multiple malnutrition indices were associated with the prevalence of peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

Keywords: Chronic kidney failure; Hypoalbuminemia; Malnutrition; Peptic ulcer.

Figure 1. Flow chart of the study population

CKD, chronic kidney disease; ESRD, end-stage renal disease; GI, gastrointestinal; ICU, intensive care unit; KT, kidney transplantation; ND-CKD, non-dialytic CKD; PUD, peptic ulcer disease.