Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis

Roland Hágendorn, Nelli Farkas, Áron Vincze, Zoltán Gyöngyi, Dezso Csupor, Judit Bajor, Bálint Eross, Péter Csécsei, Andrea Vasas, Zsolt Szakács, László Szapáry, Péter Hegyi, Alexandra Mikó

Research output: Article

3 Citations (Scopus)

Abstract

AIM To understand the influence of chronic kidney disease (CKD) on mortality, need for transfusion and rebleeding in gastrointestinal (GI) bleeding patients. METHODS A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or end-stage renal disease (ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization (LOH). Calculations were performed with Comprehensive Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane's Q and I2 statistics. Mean difference (MD) and OR (odds ratio) were calculated. RESULTS 1063 articles (EMBASE: 589; PubMed: 459; Cochrane: 15) were found in total. 5 retrospective articles and 1 prospective study were available for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group (OR = 1.786, 95%CI: 1.689-1.888, P < 0.001) and the ESRD group (OR = 2.530, 95%CI: 1.386-4.616, P = 0.002), and a rebleeding rate (OR = 2.510, 95%CI: 1.521-4.144, P < 0.001) in patients with impaired renal function. CKD patients required more unit red blood cell transfusion (MD = 1.863, 95%CI: 0.812-2.915, P < 0.001) and spent more time in hospital (MD = 13.245, 95%CI: 6.886-19.623,P < 0.001) than the controls. CONCLUSION ESRD increases mortality, need for transfusion, rebleeding rate and LOH among GI bleeding patients. Prospective patient registries and observational clinical trials are crucially needed.

Original languageEnglish
Pages (from-to)8415-8425
Number of pages11
JournalWorld journal of gastroenterology
Volume23
Issue number47
DOIs
Publication statusPublished - dec. 21 2017

ASJC Scopus subject areas

  • Gastroenterology

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