Proton-pump inhibitors for prevention of upper gastrointestinal bleeding in patients undergoing dialysis

Table 1 Clinical characteristics of patients according to proton-pump inhibitor use

Characteristic	PPI group(n = 175)	Control group(n = 369)
Age, yr	63.9 ± 12.8	62.7 ± 14.5
Follow-up (mo)	55.7 ± 33.6a	66.5 ± 37.5
Sex, male	98 (57.1)	201 (54.5)
Hypertension	99 (56.6)	215 (58.3)
Diabetes	90 (51.4)	203 (55.0)
Smoking	11 (40.7)	4 (12.1)
Hemodialysis	153 (87.4)	333 (90.24)
Body mass index (kg/m2)	23.4 ± 3.2	23.5 ± 3.9
Previous cardiovascular disease
Cerebrovascular accident	18 (10.3)	49 (13.3)
Coronary heart disease	28 (16.0)	68 (18.4)
Chronic liver disease	2 (1.1)	3 (0.8)
Aspirin use	82 (46.9)	175 (47.4)
Dual anti-platelet therapy	15 (8.6)	32 (8.7)
Warfarin	9 (5.1)	8 (2.2)
Helicobacter pyroli
Positive	36 (6.0)	53 (15.0)
No test	139 (79.4)	316 (85.6)
Baseline laboratory findings
Hemoglobin (g/L)	9.1 ± 1.6	8.8 ± 1.6
Hematocrit (%)	27.3 ± 5.3	26.2 ± 5.1
Creatinine (mmol/L)	6.7 ± 2.9	7.2 ± 3.2
Protein (g/L)	7.3 ± 0.9	7.2 ± 0.9
Albumin (g/L)	4.1 ± 0.9	3.9 ± 0.6
C-reactive protein (mg/L)	11.0 ± 18.8	9.6 ± 17.2
Death	7 (4.0)	18 (4.9)

Data are presented as mean ± SD, or n (%); ^aP < 0.05 vs control. PPI: Proton-pump inhibitors.

Table 2 Causes of upper gastrointestinal bleeding in patients with end-stage renal disease

Cause	Patients (n)
Gastric ulcer	19
Duodenal ulcer	7
Duodenal and gastric ulcer	1
Dieulafoy’s lesion	7
Mallory-Weiss tear	2
Gastric erosion	2
Duodenal erosion	2
Gastric cancer	1

Table 3 Predictors for upper gastrointestinal bleeding in patients with end-stage renal disease

Variable	HR	95%CI	P value
PPI (no treatment vs treatment)	13.689	1.84-101.64	0.011
Warfarin	4.728	1.57-14.25	0.006
Anti-platelet therapy	2.476	1.38-4.44	0.002
Coronary artery disease	2.079	0.954-4.532	0.094
Cerebrovascular disease	1.492	0.973-2.287	0.067
Smoking	2.154	0.659-7.043	0.204
Diabetes	1.020	0.48-2.30	0.899
Hypertension	1.318	0.59-2.92	0.497
Age	1.002	0.97-1.03	0.870

All models were adjusted for age, sex, diabetes, hypertension, smoking, coronary heart disease, cerebrovascular disease, hemoglobin, albumin and mode of dialysis. PPI: Proton-pump inhibitor.