Korean J Gastrointest Endosc > Volume 32(6); 2006 > Article
Korean Journal of Gastrointestinal Endoscopy 2006;32(6): 374-380.
만성 신부전 환자에서 발생한 위장관 출혈의 임상적 특징
김형근·김영수·조영석·지정선·김성수·김영옥·윤선애·채현석·최규용·정인식
가톨릭대학교 의과대학 내과학교실
Clinical Features of Gastrointestinal Bleeding in Patients with Chronic Renal Failure
Hyung Keun Kim, M.D., Young-Soo Kim, M.D., Young Seok Cho, M.D., Jeong-Seon Ji, M.D., Sung Soo Kim, M.D., Young Ok Kim, M.D., Sun-Ae Yun, M.D., Hiun Suk Chae, M.D., Kyu Yong Choi, M.D. and In Sik Chung, M.D.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Abstract

Background/Aims:
Gastrointestinal bleeding (GIB) in patients with chronic renal failure (CRF) is a common complication with a high mortality. However, the cause or mechanism of this condition is unclear. Therefore, this study investigated the clinical features of GIB in patients with CRF.
Methods:
The clinical features of 35 patients with CRF who were admitted to the Uijeongbu St. Mary's Hospital for GIB from January 1998 to August 2003 were examined retrospectively.
Results:
Thirty-five out of 803 patients had CRF (4.4%). The mean age of those with CRF was 62⁑11 years and 16 patients were male. The treatment for CRF was hemodialysis in 22 (62.9%), pre-dialysis in 10 (28.6%) and peritoneal dialysis in 3 (8.6%). The cause of GIB in CRF patients was an ulcer (45.7%), vascular disease (37.1%), hemorrhagic gastritis (8.6%), and Mallory-Weiss laceration (2.9%), etc. Rebleeding after the first treatment occurred in 5 patients (14.3%). Three of these patients (60%) had vascular disease. Surgical treatment for rebleeding was performed in 3 patients (60%) and the mortality rate in rebleeding patients was 60%.
Conclusions:
The most common cause of GIB in CRF patients is an ulcer followed by vascular disease. Vascular disease in cases with rebleeding is high with a high mortality rate. (Korean J Gastrointest Endosc 2006;32:374⁣380)
Key Words: Chronic renal failure, Gastrointestinal bleeding, Vascular disease
주요어: 만성 신부전, 위장관 출혈, 혈관 질환
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