PREVALENCE OF LESIONS PREDISPOSING TO ANEMIA IN THE UPPER GASTROINTESTINAL TRACT IN END-STAGE RENAL DISEASE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Document Type

Conference Proceeding

Publication Date

6-1-2024

Publication Title

Gastrointest Endosc

Abstract

Introduction: Anemia is often seen in patients with end-stage renal disease (ESRD), and is associated with an increased risk of cardiovascular events and mortality. Anemia in patients with ESRD is often associated with arteriovenous malformations (AVMs). However, anemia in ESRD patients can also occur due to decreased substrate availability or inadequate response of bone marrow for proliferation. In addition, these patients are predisposed to developing gastric inflammation and ulceration due to hyperparathyroidism, hypergastrinemia, back diffusion of H+ ions, delayed gastric emptying, H. pylori infection, and poor cytoprotection. We conducted a systematic review and meta-analysis to assess the risk of upper (gastrointestinal) GI tract lesions that can predispose to anemia in ESRD patients as compared to the healthy population. Methodology: We conducted a comprehensive search of multiple databases including Medline/PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library on June 8, 2023. Studies investigating the prevalence of peptic ulcer disease, esophagitis, gastritis, and duodenitis in adults > 18 years of age were included in the study. We excluded studies in the pediatric population, animal studies, articles not in the English language, case series with <10 patients, or studies without a control group. Results: Out of the initial 5252 citations, 21 studies including 71,805 patients with ESRD and 86,314 healthy controls were analyzed. ESRD patients had similar odds of peptic ulcer disease (PUD) as compared to healthy individuals [OR: 1.06; 95% CI: 0.65, 1.72; p-value = 0.82]. Patients on hemodialysis had higher odds of developing peptic ulcers when compared to healthy individuals [OR:1.62; 95% CI: 0.99, 2.65, p-value = 0.05]. ESRD patients had similar odds of developing esophagitis [OR: 1.98; 95% CI: 0.67-5.84; p-value=0.21] but higher odds of developing gastritis [OR: 1.63; 95% CI: 1.02, 2.60; p-value= 0.04], and duodenitis [OR: 1.70; 95% CI: 1.00, 2.90; p=0.05] as compared to healthy controls. Conclusion: We conclude that patients with ESRD have similar odds of developing peptic ulcer disease, but slightly higher odds of developing gastritis and duodenitis than the healthy population. Despite a predisposition to gastric inflammation and ulceration, ESRD doesn’t confer a clinically significant increased risk of peptic ulcer disease or chronic gastritis and duodenitis.

Volume

99

Issue

6

First Page

AB1149

Last Page

AB1150

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