ETIOLOGIC PROFILE OF UPPER GASTROINTESTINAL BLEEDING IN CHRONIC RENAL FAILURE

Aims:

Upper gastrointestinal bleeding is more common in patients with chronic renal failure than in the general population. They are a source of serious health problems – even early deaths – for most patients with this condition. The purpose of our work is to report the different etiologies of upper gastrointestinal bleeding in these patients.

Methods:

This is a retrospective study conducted in the service of Hepato Gastroenterology I of the Military Hospital of Rabat between January 2011 and March 2014. All patients with chronic renal insufficiency presenting with high digestive haemorrhages had benefited from a high digestive endoscopy.

Results:

183 patients with chronic renal failure were explored endoscopically. There are 144 men and 39 women, a sex ratio H/F of 3.7. The average age was 57.6 +/- 11.6 years old. The indications for gastroscopy were mainly presented by iron deficiency anemia in 108 patients (59%) and externalized gastrointestinal bleeding (hematemesis and melena) in 75 patients (41%). Gastroscopy showed a bulbar ulcer in 81 patients (44.2%), erosive gastritis in 57 patients (31.1%), peptic esophagitis in 27 patients (14.7%) and angiodysplasias in 18 patients (9, 8%).

Conclusions:

In our series, bulbar ulcer is responsible for upper gastrointestinal bleeding in almost half of patients with chronic renal failure. The importance of these lesions suggests a systematic high digestive endoscopy in case of chronic kidney disease.