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Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis

Roland Hágendorn1, Nelli Farkas2, Áron Vincze1

  • 1Department of Gastroenterology, First Department of Medicine, University of Pécs, Pécs 7624, Hungary.

World Journal of Gastroenterology
|January 9, 2018
PubMed

Insights

Patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) face higher mortality, rebleeding rates, and transfusion needs when experiencing gastrointestinal (GI) bleeding. Further research is essential to improve outcomes for these vulnerable patients.

Area of Science:

  • Nephrology
  • Gastroenterology
  • Clinical Research

Background:

  • Gastrointestinal (GI) bleeding is a common clinical emergency.
  • Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are prevalent conditions that may affect GI bleeding outcomes.
  • Limited data exist on the specific impact of renal impairment on GI bleeding prognosis.

Purpose of the Study:

  • To evaluate the influence of CKD and ESRD on mortality, transfusion requirements, and rebleeding rates in patients with GI bleeding.
  • To assess the impact of renal disease on length of hospitalization for GI bleeding.

Main Methods:

  • A systematic literature search was performed across EMBASE, PubMed, and Cochrane databases.
  • Included studies reported on GI bleeding patients with CKD or ESRD and their outcomes.
  • Meta-analysis was conducted using Comprehensive Meta-Analysis software with random effects models.

Main Results:

  • Analysis of 6 studies (406,035 patients) revealed significantly higher mortality in CKD (OR=1.786) and ESRD (OR=2.530) groups.
  • Patients with impaired renal function experienced increased rebleeding rates (OR=2.510).
  • CKD patients required more red blood cell transfusions (MD=1.863) and had longer hospital stays (MD=13.245).

Conclusions:

  • ESRD significantly increases mortality, transfusion needs, rebleeding rates, and length of hospitalization in GI bleeding patients.
  • CKD also adversely affects these outcomes.
  • Prospective patient registries and observational clinical trials are needed to further elucidate these findings.
Abstract

Keywords:
Blood transfusionChronic kidney diseaseGastrointestinal bleedingMortalityRebleeding

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