Analysis on the Uremic Bleeding in Patients of Chronic Renal Failure

Lee, Yoon Chul; Cho, Young Wook; Bae, Woo Kyun; Woo, Hak; Lee, Yun Kyung; Cho, Min Seok; Kim, Hyun Soo; Ma, Seoung Kwon; Kim, Nam Ho; Choi, Ki Chul

Abstract

Manifestations of uremic state include anorexia, nausea, uremic bleeding, vomiting, pericarditis, peripheral neuropathy or central nervous system abnormalities. Of these, uremic bleeding is one of the most important causes of morbidity and mortality. We investigated the epidemiology of the uremic bleeding and compared with that of the control group among patients with chronic renal failure. This study included 104 patients in the uremic bleeding group and 102 patients in the control group from January 2000 to September 2003 admitted to the Chonnam National University Hospital. A retrospective analysis was conducted for the variables of sex, age, hemodialysis method, bleeding site and laboratory finding associated with bleeding tendency and uremia. The results were as follows: 1) The uremic bleeding group was more aged than the control group (p=0.001). 2) The use of erythropoietin or Hemocontin(R) in the uremic bleeding group was significantly less than in the control group (p=0.001). 3) Mean Bleeding time was 2.38 seconds in the uremic bleeding group and 1.98 seconds in the control group (p=0.032). 4) Mean hemoglobin level was 7.813 g/dl in the uremic bleeding group and 9.038 g/dl in the control group (p=0.049). 5) The most common complication of the uremic bleeding group was gastrointestinal (GI) bleeding (86 patients (82.7%)) - upper GI bleeding and peptic ulcer bleeding was more common. We concluded that hemoglobin level and bleeding time should be controlled to prevent uremic bleeding. And also peptic ulcer, the most common cause of uremic bleeding, should be rigorously treated.