Emergency Gastrointestinal Bleeding in DialysisPatients:Five Years' Experience in a Single Dialysis Center

Background and Study aims: Dialysis patients can develop a number of gastrointestinal (GI) lesions that can result in bleeding in emergency situations. Our aim was to investigate the nature of GI bleeding that needed emergency endoscopy. Patients and Methods: Over a 5-year period (April 1, 2007-March 31, 2012), we studied consecutive dialysis patients with GI bleeding who underwent emergency endoscopic procedures. Demographic and clinical data were also collected. Results: Fifty-two patients were hospitalized for emergency GI bleeding and underwent a subsequent endoscopy. The locations of lesions involved in GI bleeding were: upper GI (n=34), lower GI (n=14), and unknown (n=4). Duodenal ulcer (26%) and gastric antral vascular ectasia (26%) were the most frequently identified causes of upper GI bleeding, followed by gastric ulcer (14%). In patients with lower GI bleeding, colorectal cancer, angiodysplasia and ischemic enteritis were identified in equal numbers (21%). Two thirds of patients with gastric antral vascular ectasia had recurrence in spite of treatment by argon plasma coagulation. Conclusion: The causes of GI bleeding in dialysis patients in emergency situations may differ from those in non-dialysis patients with GI bleeding.