To investigate the status of peptic ulcers and the associated risk factors among patients undergoing hemodialysis

This hospital-based retrospective study was conducted from October 1, 2018, to March 24, 2024, among patients undergoing renal replacement therapy who received endoscopic services at the endoscopy unit of Shinonmed Hospital. We reviewed their upper gastrointestinal endoscopy findings and hemodialysis-related medical history. To calculate the malnutrition index, we used the calculator developed by Dr. Gordan P. Buzby from the University of Pennsylvania Health System, which is published on PubMed.

1. General Characteristics of the Study Population

A total of 103 cases were included in the study. The mean age was 48.7 ± 12.8 years. By sex distribution, 47% (n=48) were female and 53% (n=55) were male, yielding a male-to-female ratio of 1:1.

 Among the 103 patients, 35% (n=36) had peptic ulcer disease (PUD), while 65% (n=67) did not.

Assessment of the association between H. pylori infection and PUD showed that 84.7% (n=87) had no H. pylori infection. The association with PUD was not statistically significant (p = 0.15).

Malnutrition Index and Peptic Ulcer Disease

PUD was detected in 34.9% (n=36) of all cases. Based on the malnutrition index, 75% (n=27) of patients with peptic ulcers had moderate malnutrition. Therefore, protein–energy malnutrition was found to be significantly associated with the development of peptic ulcers (p = 0.000*).

Age and Peptic Ulcer Disease

Among patients with PUD, 69.4% (n=25) were aged >40 years, while 77.6% (n=52) of non-PUD patients were also over 40 years of age. There was no significant association between age and PUD (p = 0.23).

Comorbidities and Peptic Ulcer Disease

Among patients with PUD, 47.2% (n=17) had three or more chronic comorbidities, compared with 23.8% (n=16) among those without PUD. Thus, the presence of multiple comorbidities was significantly associated with the development of PUD (p = 0.038)

Risk Factors for PUD in Hemodialysis Patients

Comparison of risk factors among hemodialysis patients revealed that the malnutrition index was strongly associated with PUD (p = 0.000*). Additionally, comorbid conditions increased the risk of PUD by 35.1 times

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1. A total of 103 patients undergoing renal replacement therapy were evaluated by endoscopy, of whom 36 (34.95%) had peptic ulcers and 98 (95.1%) were diagnosed with chronic gastritis.
2. Peptic ulcer disease was present in 34.9% (n=36) of the cases. Based on the malnutrition index, 75% (n=27) of patients with peptic ulcers had moderate malnutrition. This indicates that protein–energy malnutrition contributes to the development of peptic ulcers.