ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG XUẤT HUYẾT TIÊU HOÁ CAO TRÊN BỆNH NHÂN SUY THẬN MẠN

Abstract

Objectives: To describe the clinical and subclinical characteristics of upper gastrointestinal bleeding in patients with chronic kidney disease. Subjects and Methods: A cross-sectional descriptive study was conducted on 80 chronic kidney disease patients with upper gastrointestinal bleeding who underwent esophagogastroduodenoscopy and were treated as inpatients at the Gastroenterology and Hepatology center, Bach Mai Hospital, from September 2024 to May 2025. Results: The average age of patients was 68.3 ± 14.7 years. Males predominated at a ratio: 4:1. Of the patients, 28.8% were undergoing dialysis, 25% had a history of gastrointestinal bleeding, and 40% had a history of related medication use. The most common symptom was melena at 67.4%. All patients presented with anemia. The main cause of gastrointestinal bleeding was peptic ulcer disease, with the most common locations being the duodenal bulb and the antrum. Of the patients with peptic ulcers, 62.3% had a high risk (Forrest IA-FIIB) and required hemostatic intervention. Based on the Rockall score, all patients had a moderate to high risk, with the majority (91.2%) being in the moderate-risk group. Conclusion: In patients with chronic kidney disease, the main cause of bleeding was peptic ulcer disease, most commonly located in the duodenal bulb, with patients falling into the moderate-to-high risk group according to the Rockall score.