EPIDEMIOLOGICAL AND LESIONAL ASPECT OF UPPER GASTROINTESTINAL BLEEDING IN CHRONIC KIDNEY FAILURE

Aims:

The objective of our study is to determine the epidemiological, lesional profile of upper gastrointestinal bleeding in the chronic kidney failure.

Methods:

This is a retrospective and a prospective (from March 2015 to March 2017) descriptive and analytical study during a period of 22 months, including all The chronic kidney failure (CKF) admitted for digestive bleeding. Epidemiological, clinical, endoscopic, therapeutic and evolutionary data were treated.

Results:

Of the 266 patients admitted to the hepato-gastroenterology department for upper gastrointestinal bleeding, 32 were in (CKF) (8.27%), the mean age was 53.5 years, a history of upper gastrointestinal bleeding was noted in 6.25% cases, associated heart disease in 25% cases, diabetes in 50% cases, hypertension in 53.12% of cases, and Associated cirrhosis in 6.25% cases. On the endoscopic level, the presence of red blood was noted in 21.8% with active bleeding in 12.5% cases. The endoscopic lesions noted were: ulcer disease in 37.5% vs. 38.8% in subjects with normal renal function, p = NS, oesophagitis in 34.3% vs. 11.1%, p = 0.001, oesophageal variceal rupture in 6.25% vs. 25.5%, p = NS, Dieulafoy ulcer in 6.25% vs. 0, p < 0.001, angiodysplasia in 6.25% vs. 2.1%, p = NS, and erosive hiatal hernia in 3.12% vs. 0%, p = NS. In terms of progression, the persistence of haemorrhage was noted in 15.2% of cases, of which 6.25% required surgery. Three cases of death were noted (9.3%), 2 of which were related to upper gastrointestinal haemorrhage, with a statistically significant relationship between mortality and presence of nephropathy p = 0.023.

Conclusions:

GI lesions during CKF cause severe digestive bleeding dominated by ulcerative disease.