A Cross-sectional Study by Esophagogastroduodenoscopy for Occult Bleeding in Chronic Hemodialysis Patients at Tanta in Egypt

Background and study aims: Chronic hemodialysis patients are susceptible to a lot of complications. Gastrointestinal bleeding is one of the most serious and important complications in these patients result from many contributing factors like chronic uremia, stress and drugs. The present study is concerned with assessment the magnitude of occult gastrointestinal bleeding in chronic hemodialysis patients. Moreover we analyzed type and site of lesions accused in this bleeding. Patients and methods: this study was performed in the period from April 2013 to October 2013, included a ninety chronic hemodialysis patients; fifty three males (58.9%) and thirty seven females (41.1%), at the Nephrology and Hemodialysis unit of Tanta university hospital, all patients investigated for occult bleeding by fecal occult blood test and detecting iron deficiency anemia, and those positive occult bleeding patients were the target of this study to be investigated by esophagogastroduodenoscopy (EGD). If EGD was normal; further colonoscopy was performed however it is not the interest of this study. Results: 23/90 (25.6%) chronic hemodialysis patients were diagnosed to be suffering from occult bleeding. Fecal occult blood test, iron deficiency anemia and both of them were positive in 9, 11 and 3 patients respectively. EGD succeeded to detect source of bleeding in 11/14 occult bleeding chronic hemodialysis patients (78.6%). Stomach (61.1%) and erosions (38.8%) were the most common site and cause of occult bleeding in the studied chronic hemodialysis patients respectively. Conclusions: Occult bleeding was not infrequent in this study (25.6%); Moreover, Upper gastrointestinal lesions detected by EGD were common in the studied chronic hemodialysis patients with occult bleeding (78.6%). Stomach and erosions were the most common site and type of lesions respectively.