Gastrointestinal bleeding in chronic kidney disease patients: a systematic review and meta-analysis
Lin, Yanshan and Li, Chunqun and Waters, David and Kwok, Chun Shing (2023) Gastrointestinal bleeding in chronic kidney disease patients: a systematic review and meta-analysis. Renal Failure, 45 (2). ISSN 0886-022X
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Abstract
Abstract
Gastrointestinal bleeding (GIB) is a major cause of mortality in patients with renal failure. We conducted a systematic review of the literature to evaluate the rates, predictors, and outcomes of GIB in patients with chronic kidney disease (CKD). A search of MEDLINE and EMBASE databases was performed, and data were extracted from relevant studies. Statistical pooling was performed to determine the rate of GIB in patients with CKD, and a random-effect meta-analysis was performed to determine the predictors of GIB and mortality in patients with GIB. Twenty-two studies were included in this review, with 7,810,273 patients with CKD included in the analysis. The pooled results of five studies suggested that the rate of GIB in patients with CKD was 2.2%, and among the studies in which patients with CKD underwent endoscopy, the pooled results for GIB were 35.8%. Receipt of dialysis (OR 14.48, 95%CI 4.96–42.32), older age (OR 1.03, 95%CI 1.02–1.05), diabetes mellitus (OR 1.30, 95%CI 1.22–1.39), history of ulcers (OR 1.53, 95%CI 1.03–2.26), and cirrhosis (OR 1.73, 95%CI 1.41–2.12) were significantly associated with GIB. The pooled results suggest a twofold increase in the odds of mortality with GIB, with significant heterogeneity (OR 2.12, 95%CI 1.45–3.10, I2 = 93%). GIB in patients with CKD affects 2% of patients but can be greater in the group of patients who underwent endoscopy. Receipt of dialysis is a strong predictor of GIB, and sustained GIB is associated with a twofold increase in the odds of mortality compared to patients without GIB.
Key points
The rate of gastrointestinal bleeding (GIB) in patients with chronic kidney disease (CKD) was 2.2%.
The rate of GIB in patients with CKD is higher in those who undergo endoscopy.
Dialysis, older age, diabetes mellitus, history of ulcers, and cirrhosis were significantly associated with GIB in CKD.
GIB in patients with CKD was associated with a twofold increase in the odds of mortality.
| Item Type: | Article | ||||||
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| Identification Number: | https://doi.org/10.1080/0886022X.2023.2276908 | ||||||
| Dates: |
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| Uncontrolled Keywords: | Chronic kidney disease, gastrointestinal bleeding, mortality, risk factors | ||||||
| Subjects: | CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific) | ||||||
| Divisions: | Faculty of Health, Education and Life Sciences > School of Health Sciences | ||||||
| Depositing User: | Gemma Tonks | ||||||
| Date Deposited: | 30 Nov 2023 16:01 | ||||||
| Last Modified: | 30 Nov 2023 16:01 | ||||||
| URI: | https://www.open-access.bcu.ac.uk/id/eprint/15032 |
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