bleed in CKD patients

Q: In patients with severe chronic kidney disease (CKD), which is a more common gastrointestinal (GI) bleed due to underlying uremia? (select one)

A) Upper GI 

B) Lower GI

Answer: B

A massive Canadian data collected over 10 years from 1998 to 2008 of over 11,000 patients, published in 2014, showed the following frequency of bleed in older renal patients (>65 years) who initiated chronic dialysis.

• Lower GI tract – 9 percent
• Upper GI tract – 6 percent
• Intracerebral – 1 percent
• Subarachnoid – 0.1 percent

Recent data published of about 6000 renal patients of all categories showed that they have almost double the likelihood of having intracerebral bleeding over non-renal patients.

#nephrology

#hematology

References:

1. Sood MM, Bota SE, McArthur E, et al. The three-year incidence of major hemorrhage among older adults initiating chronic dialysis. Can J Kidney Health Dis 2014; 1:21.

2. Vanent KN, Leasure AC, Acosta JN, et al. Association of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage. JAMA Neurol 2022; 79:911.