GASTROINTESTINAL-BLEEDING IN PATIENTS ON HEMODIALYSIS

We retrospectively analyzed 125 episodes of gastrointestinal bleeding (GB) in 66 patients undergoing periodic hemodialysis from January 1976 to December 1990. The prevalence of GB was 8 %. There was a predomina nce in males (68.2 %). The mean age of the patients was 54 years (rang e, 20 to 77 years). They had been on dialysis for an average of 4 year s (range, 1 month to 13 years). We had observed a greater prevalence o f GB in patients suffered from interstitial nephropathy (24.2 %). The most frequent causes of GB were erosive gastritis and duodenal ulcer ( 14.4 % of cases each). Gastrointestinal angio-displasia was the source of bleeding in 4 % of episodes. We observed a greater bleeding tenden cy in patients who had any episode of GB of unknown etiology. Differen t causes of GB were wich found in the majority of patients who present ed repeatedly bleeding episodes. The 66.4 % of episodes were resolved with medical treatment (antacids, H-2-receptor antagonists and/or estr ogens), 16.8 % with measures of endoscopic hemostasia and 16.8 % with surgery. The overall mortality was 1.5 %.