Am J Nephrol. 2010;32(3):212-218. doi: 10.1159/000316963. Epub 2010 Jul 16.
Compared to the general population, patients with end-stage renal disease (ESRD) have increased peptic ulcer and upper GI bleeding complication rates. However, the risk factors for peptic ulcer among ESRD patients are unknown.
In this retrospective study, we enrolled 827 incident dialysis patients and diagnosed peptic ulcer on the basis of endoscopic findings; information on the morbidities and medical prescription were obtained directly from medical records. A Cox regression hazard model was used to identify risk factors for peptic ulcer.
During the 10-year study period, 481 patients underwent an endoscopic exam. Peptic ulcers were detected in 153 patients. Age (p = 0.025), peritoneal dialysis (p = 0.022), diabetes mellitus (p = 0.020), congestive heart failure (p = 0.015), low serum albumin (p = 0.008) and high gamma-glutamyl transpeptidase (γ-GT) levels (p = 0.002) are risk factors for peptic ulcers among ESRD patients. Ulcer severity (p = 0.004) and aspirin prescription (p = 0.043), but not Helicobacter pylori infection, influenced the ulcer recurrence rate.
The risk factors for peptic ulcer have some differences between ESRD patients and general population. In patients with high risk of upper GI bleeding, peritoneal dialysis and aspirin should be prescribed with caution.
与普通人群相比，终末期肾病（ESRD）患者的消化性溃疡和上消化道出血并发症发生率更高。然而，ESRD 患者发生消化性溃疡的危险因素尚不清楚。
在这项回顾性研究中，我们纳入了 827 例新开始透析的患者，并根据内镜检查结果诊断消化性溃疡；通过直接查阅病历获得有关疾病和药物处方的信息。采用 Cox 回归风险模型确定消化性溃疡的危险因素。
在 10 年的研究期间，481 例患者接受了内镜检查。在 153 例患者中发现了消化性溃疡。年龄（p = 0.025）、腹膜透析（p = 0.022）、糖尿病（p = 0.020）、充血性心力衰竭（p = 0.015）、低血清白蛋白（p = 0.008）和高谷氨酰转肽酶（γ-GT）水平（p = 0.002）是 ESRD 患者发生消化性溃疡的危险因素。溃疡严重程度（p = 0.004）和阿司匹林处方（p = 0.043）而不是幽门螺杆菌感染影响溃疡复发率。
消化性溃疡的危险因素在 ESRD 患者和普通人群之间存在一些差异。在上消化道出血风险较高的患者中，应谨慎使用腹膜透析和阿司匹林。
