ANEMIA AND ENDOSCOPIC GASTRODUODENITIS IN PREDIALYSIS PATIENTS

The extent of pre-dialysis anaemia in Asian patients and the contribut ion of gastrointestinal blood loss to anaemia are unknown. Of 76 new d ialysis patients in our unit in 1994, 7.9% of patients had a haemoglob in (Hb) < 6 g/dL; 53.9% had Hb greater than or equal to 6 - < 8 g/dL; 28.9% had an Hb greater than or equal to 8 - < 10 g/dL and 9.2% had Hb greater than or equal to 10 g/dL in the 2 months before dialysis. Gas troduodenoscopy in 38 patients 2 months pre-dialysis (excluding 1 pati ent each with chronic duodenal ulcer and overt haemorrhagic gastritis) , showed that 16.7% were normal, while the rest had mucosal erythema, erosions or petechiae alone or in combination. Haemoglobin was signifi cantly lower in patients with endoscopic petechiae (n = 23, Hb 7.24 +/ - 1.28 g/dL) compared with those without (n = 13, Hb 8.35 +/- 1.29 g/d L), although preceding blood transfusions were similar. No differences in Hb were noted in patients with or without endoscopic erythema or e rosions, respectively. It is possible that occult blood loss associate d with gastroduodenal petechiae exacerbates anaemia in chronic renal f ailure (CRF).