Authors: M. Merta Authors‘ workplace: Nefrologická ambulance, Affidea Nefromed s. r. o., Praha Published in: Gastroent Hepatol 2026; 80(1): 49-53 Category: doi: https://doi.org/10.48095/ccgh202649
Gastrointestinal bleeding (GIB) occurs more frequently and has greater clinical impact in patients with chronic kidney disease (CKD) than in patients without kidney disease. Current data prove that advanced stages of CKD, especially chronic renal failure (CRF), are independent risk factors for GIB. Hemodialysis treatment is a specific independent factor for GIB in CKD patients. Increased risk of GIB in CKD patients manifests by higher incidence and length of hospitalizations and higher mortality. The clinical condition of patients with advanced CKD and especially with CRF is usually more serious compared with patients without kidney disease. Moreover, it has been shown that the ability to provide these patients with an efficient treatment, especially early endoscopy, is decreased, which is partly associated with increased mortality. These findings suggest that greater attention should be paid to the topic of GIT in order to improve the outcomes and decrease the mortality of these patients.
chronic kidney disease – hemodialysis – gastrointestinal bleeding – endoscopy – mortality
1. Bikbov B, Purcell CA, Levey AS et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395 (10225): 709–733. doi: 10.1016/S0140-6736 (20) 30045-3.
2. Teplan V, Marečková O, Lukáš M. Onemocnění gastrointestinálního traktu a choroby ledvin. Gastroent Hepatol 2018; 72 (1): 50–57. doi: 10.14735/amgh201850.
3. Zoccali C, Vanholder R, Massy ZA et al. The systemic nature of CKD. Nat Rev Nephrol 2017; 13 (6): 344–358. doi: 10.1038/nrneph.2017.52.
4. Krishnan A, Venkataraman J. Gastrointestinal evaluation in chronic kidney diseases. J Nephrol Ther 2011; 1 (3): 110. doi: 10.4172/2161-0959. 1000110.
5. Chung SY, Barnes JL, Astroth KS. Gastrointestinal microbiota in patients with chronic kidney disease: a systematic review. Adv Nutr 2019; 10 (5): 888–901. doi: 10.1093/advances/nmz028.
6. Wuerth BA, Rockey DC. Changing epidemiology of upper gastrointestinal hemorrhage in the last decade: a nationwide analysis. Dig Dis Sci 2018; 63 (5): 1286–1293. doi: 10.1007/s10620-017-4882-6.
7. He M, Shah AD, Wang Y et al. Impact of CKD/kidney failure on angiodysplasia-related gastroinestinal bleeding: incidence, outcomes and readmission risk in a national cohort. Kidney360 2025; 6 (10): 1689–1701. doi: 10.34067/KID.0000000901.
8. Barkun AN, Almadi M, Kuipers EJ et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med 2019; 171 (11): 805–822. doi: 10.7326/M19-1795.
9. Sami SS, Al-Araji SA, Ragunath K. Review article: gastrointestinal angiodysplasia – pathogenesis, diagnosis and management. Aliment Pharmacol Ther 2014; 39 (1): 15–34. doi: 10.1111/apt.12527.
10. Lin Y, Li C, Waters D et al. Gastrointestinal bleeding in chronic kidney disease patients: a systematic review and meta-analysis. Ren Fail 2023; 45 (2): 2276908. doi: 10.1080/0886022X.2023.2276908.
11. He M, Desai S, Wang Y et al. Inpatient outcomes of gastrointestinal bleeding in advanced CKD and kidney transplant recipients: a national analysis 2016–2019. Kidney360 2025; 6 (3): 379–390. doi: 10.34067/KID.00000 00662.
12. Little DJ, Arnold M, Hedman K et al. Rates of adverse clinical events in patients with chronic kidney disease: analysis of electronic health records from the UK clinical practice research datalink linked to hospital data. BMC Nephrol 2023; 24 (1): 91. doi: 10.1186/s12882-023 - 03119-z.
13. Mahady SE, Polekhina G, Woods RL et al. Association between CKD and major hemorrhage in older person: data from the aspirin in reducing events in the elderly randomized trial. Kidney Int Rep 2023; 8 (4): 737–745. doi: 10.1016/j.ekir.2023.01.012.
14. Trivedi H, Yang J, Szabo A. Gastrointestinal bleeding in patients on long-term dialysis. J Nephrol 2015; 28 (2): 235–243. doi: 10.1007/s40620-014-0132-6.
15. Huang CH, Chao JY, Ling TC et al. Effect of dialysis modalities on risk of hospitalization for gastrointestinal bleeding. Sci Rep 2023; 13 (1): 52. doi: 10.1038/s41598-022-26 476-5.
16. Garg R, Parikh MP, Chadalvada P et al. Lower rates of endoscopy and higher mortality in end-stage renal disease patients with gastrointestinal bleeding: a propensity matched National Study. J Gastroenterol Hepatol 2022; 37 (3): 584–591. doi: 10.1111/jgh.15771.
17.Tai FWD, McAlindon ME. Non-steroidal anti-inflammatory drugs and the gastrointestinal tract. Clin Med 2021; 21 (2): 131–134. doi: 10.7861/clinmed.2021-0039.
18. Jones A, Swan D, Lisman T et al. Anticoagulation in chronic kidney disease and future perspectives. J Thromb Haemost 2024; 22 (2): 323–336. doi: 10.1016/j.jtha.2023.09.020.
19. Elrggal ME, Naga YS. Gastrointestinal bleeding in patients with CKD: the renalism continues! Kidney 2025; 6 (3): 337–339. doi: 10.34067/ KID.0000000686.
Doručeno/Submitted: 23. 1. 2026
Přijato/Accepted: 30. 1. 2026
Korespondenční autor
prof. MUDr. Miroslav Merta, CSc.
Nefrologická ambulance
Affidea Nefromed s.r.o
Africká 687/36
160 00 Praha 6
mirek.merta@seznam.cz
Don‘t have an account? Create new account
Enter the email address that you registered with. We will send you instructions on how to set a new password.
