Kidney Research and Clinical Practice 2019 Mar; 38(1): 81-89  https://doi.org/10.23876/j.krcp.18.0060
Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis
Minah Kim, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Correspondence to: Soo Wan Kim, Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea. E-mail: skimw@chonnam.ac.kr
ORCID: https://orcid.org/0000-0002-3540-9004
Received: June 19, 2018; Revised: October 27, 2018; Accepted: November 12, 2018; Published online: March 31, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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


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