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Proton-pump inhibitors for prevention of upper gastrointestinal bleeding in patients undergoing dialysis.
World J Gastroenterol. 2015 Apr 28; 21(16):4919-24.WJ

Abstract

AIM

To investigate the preventive effects of low-dose proton-pump inhibitors (PPIs) for upper gastrointestinal bleeding (UGIB) in end-stage renal disease.

METHODS

This was a retrospective cohort study that reviewed 544 patients with end-stage renal disease who started dialysis at our center between 2005 and 2013. We examined the incidence of UGIB in 175 patients treated with low-dose PPIs and 369 patients not treated with PPIs (control group).

RESULTS

During the study period, 41 patients developed UGIB, a rate of 14.4/1000 person-years. The mean time between the start of dialysis and UGIB events was 26.3 ± 29.6 mo. Bleeding occurred in only two patients in the PPI group (2.5/1000 person-years) and in 39 patients in the control group (19.2/1000 person-years). Kaplan-Meier analysis of cumulative non-bleeding survival showed that the probability of UGIB was significantly lower in the PPI group than in the control group (log-rank test, P < 0.001). Univariate analysis showed that coronary artery disease, PPI use, anti-coagulation, and anti-platelet therapy were associated with UGIB. After adjustments for the potential factors influencing risk of UGIB, PPI use was shown to be significantly beneficial in reducing UGIB compared to the control group (HR = 13.7, 95%CI: 1.8-101.6; P = 0.011).

CONCLUSION

The use of low-dose PPIs in patients with end-stage renal disease is associated with a low frequency of UGIB.

Authors+Show Affiliations

Young Rim Song, Hyung Jik Kim, Jwa-Kyung Kim, Sung Gyun Kim, Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Hallym University College of Medicine, Anyang-si 431-070, South Korea.Young Rim Song, Hyung Jik Kim, Jwa-Kyung Kim, Sung Gyun Kim, Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Hallym University College of Medicine, Anyang-si 431-070, South Korea.Young Rim Song, Hyung Jik Kim, Jwa-Kyung Kim, Sung Gyun Kim, Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Hallym University College of Medicine, Anyang-si 431-070, South Korea.Young Rim Song, Hyung Jik Kim, Jwa-Kyung Kim, Sung Gyun Kim, Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Hallym University College of Medicine, Anyang-si 431-070, South Korea.Young Rim Song, Hyung Jik Kim, Jwa-Kyung Kim, Sung Gyun Kim, Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Kidney Research Institute, Hallym University College of Medicine, Anyang-si 431-070, South Korea.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25945005

Citation

Song, Young Rim, et al. "Proton-pump Inhibitors for Prevention of Upper Gastrointestinal Bleeding in Patients Undergoing Dialysis." World Journal of Gastroenterology, vol. 21, no. 16, 2015, pp. 4919-24.
Song YR, Kim HJ, Kim JK, et al. Proton-pump inhibitors for prevention of upper gastrointestinal bleeding in patients undergoing dialysis. World J Gastroenterol. 2015;21(16):4919-24.
Song, Y. R., Kim, H. J., Kim, J. K., Kim, S. G., & Kim, S. E. (2015). Proton-pump inhibitors for prevention of upper gastrointestinal bleeding in patients undergoing dialysis. World Journal of Gastroenterology, 21(16), 4919-24. https://doi.org/10.3748/wjg.v21.i16.4919
Song YR, et al. Proton-pump Inhibitors for Prevention of Upper Gastrointestinal Bleeding in Patients Undergoing Dialysis. World J Gastroenterol. 2015 Apr 28;21(16):4919-24. PubMed PMID: 25945005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proton-pump inhibitors for prevention of upper gastrointestinal bleeding in patients undergoing dialysis. AU - Song,Young Rim, AU - Kim,Hyung Jik, AU - Kim,Jwa-Kyung, AU - Kim,Sung Gyun, AU - Kim,Sung Eun, PY - 2014/10/21/received PY - 2014/12/02/revised PY - 2015/02/12/accepted PY - 2015/5/7/entrez PY - 2015/5/7/pubmed PY - 2016/1/27/medline KW - Dialysis KW - End-stage renal disease KW - Gastrointestinal hemorrhage KW - Peptic ulcer KW - Proton pump inhibitors SP - 4919 EP - 24 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 21 IS - 16 N2 - AIM: To investigate the preventive effects of low-dose proton-pump inhibitors (PPIs) for upper gastrointestinal bleeding (UGIB) in end-stage renal disease. METHODS: This was a retrospective cohort study that reviewed 544 patients with end-stage renal disease who started dialysis at our center between 2005 and 2013. We examined the incidence of UGIB in 175 patients treated with low-dose PPIs and 369 patients not treated with PPIs (control group). RESULTS: During the study period, 41 patients developed UGIB, a rate of 14.4/1000 person-years. The mean time between the start of dialysis and UGIB events was 26.3 ± 29.6 mo. Bleeding occurred in only two patients in the PPI group (2.5/1000 person-years) and in 39 patients in the control group (19.2/1000 person-years). Kaplan-Meier analysis of cumulative non-bleeding survival showed that the probability of UGIB was significantly lower in the PPI group than in the control group (log-rank test, P < 0.001). Univariate analysis showed that coronary artery disease, PPI use, anti-coagulation, and anti-platelet therapy were associated with UGIB. After adjustments for the potential factors influencing risk of UGIB, PPI use was shown to be significantly beneficial in reducing UGIB compared to the control group (HR = 13.7, 95%CI: 1.8-101.6; P = 0.011). CONCLUSION: The use of low-dose PPIs in patients with end-stage renal disease is associated with a low frequency of UGIB. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25945005/Proton_pump_inhibitors_for_prevention_of_upper_gastrointestinal_bleeding_in_patients_undergoing_dialysis_ L2 - http://www.wjgnet.com/1007-9327/full/v21/i16/4919.htm DB - PRIME DP - Unbound Medicine ER -