Bowel infarction as a cause of death in dialysis patients

Bowel infarction as a frequent occurrence in patients with end-stage renal disease has not been previously recognized. This report describes 12 dialysis patients with nonocclusive bowel infarction. All patients with bowel infarction had large weight losses secondary to vomiting, diarrhea, or ultrafiltration when undergoing dialysis, preceding the development of this disease. Of the potential risk factors analyzed, frequent and severe hypotension (systolic blood pressure, less than 100 mm Hg) when receiving dialysis occurred more commonly in patients developing bowel infarction. The weight loss was not often recognized initially as an important compromising problem. A fatal outcome was experienced in nine of the 12 patients. We conclude that bowel infarction may be a significant cause of morbidity and mortality in dialysis patients.