Risk factors for peptic ulcer disease in renal transplant patients--11 years of experience from a single center.

BACKGROUND

Peptic ulcer disease is a common complication among renal transplant recipients and causes significant morbidity and mortality.

METHODS

From 1990 through 2000, 465 renal transplant patients were followed-up in our institute. Most patients received corticosteroids and cyclosporine-based immunosuppressive regimen. About one third (n = 156) of them received mycophenolate mofetil. Patients with endoscopy-proved peptic ulcer disease were identified by reviewing medical records. Possible risk factors were analyzed by univariate analysis and multiple logistic regression analysis.

RESULTS

Among 465 kidney transplant patients, there were 181 (38.9%) who suffered at least 1 episode of peptic ulcer disease. The most frequent types of peptic ulcer disease were gastritis, gastric ulcer, duodenal ulcer, esophagitis, duodenitis and esophageal ulcer. By multivariate analysis, the use of methylprednisolone pulse therapy (odds ratio = 3.954, 95% confidence interval = 3.154-18.312, p = 0.03) and history of pre-transplant peptic ulcer disease (odds ratio = 7.599, 95% CI = 1.211-12.905, p < 0.0001) were independent risk factors for posttransplant peptic ulcer disease.

CONCLUSIONS

Our findings demonstrated that renal transplant patients who undergo methylprednisolone pulse therapy for acute rejection or who have a history of pre-transplant peptic ulcer disease carry a high risk for the development of peptic ulcer disease and deserve intensive antiulcer treatment.