Treatment of peptic ulcer in renal failure

The occurrence and pathophysiology of peptic ulcer was studied in 117 uraemic patients. Ulcer disease was unusually frequent, and the highest incidence was found in patients on regular dialysis (48%). Factors implicated were hyperacidity, hypergastrinaemia, and the effect of dialysis itself. We found that the occurrence of gastrointestinal bleeding was lower post-transplant (7%), than pre-transplant (15%), and that bleeding in renal transplant patients was due more commonly to erosive gastritis than peptic ulcer. Cimetidene was given to 9 regular dialysis patients with peptic ulcer. Symptomatic relief and significant reduction of acid secretion was demonstrated, and no major side effects occured. There is a logical basis for conservative treatment of uncomplicated peptic ulcer in the dialysis patient, and further evaluation of cimetidene is indicated.