Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.

<h4>Objectives</h4>We aimed at determining peptic ulcer disease (PUD) incidence among chronic kidney disease (CKD) patients during 1998-2008, compared to patients without CKD, and at examining associations between CKD and PUD.<h4>Methods</h4>Data for 1998-2008 were extracted...

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Autores principales:	Chih-Chia Liang, Chih-Hsin Muo, I-Kuan Wang, Chiz-Tzung Chang, Che-Yi Chou, Jiung-Hsiun Liu, Tzung-Hai Yen, Chiu-Ching Huang, Chi-Jung Chung
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5e9cda35900c4323af0d49de1585649d
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spelling	oai:doaj.org-article:5e9cda35900c4323af0d49de1585649d2021-11-18T08:34:07ZPeptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.1932-620310.1371/journal.pone.0087952https://doaj.org/article/5e9cda35900c4323af0d49de1585649d2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24498412/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>We aimed at determining peptic ulcer disease (PUD) incidence among chronic kidney disease (CKD) patients during 1998-2008, compared to patients without CKD, and at examining associations between CKD and PUD.<h4>Methods</h4>Data for 1998-2008 were extracted from the National Health Insurance Research Database in Taiwan. The annual PUD incidence (cases per thousand persons per year) was calculated separately for patients with and without CKD. Characteristics of patients with newly diagnosed PUD (n = 16322) were compared to those of a control group without PUD (n = 32644). The 2 groups were matched for age, sex, and index year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression.<h4>Results</h4>Over the 10-year period, the PUD incidence was ∼10-12 times higher in CKD patients than in those without CKD. Its incidence in elderly CKD patients increased rapidly over time. For CKD patients, most PUD events (>95%) were managed during hospitalization. Peptic ulcer risk, adjusted for all potential confounders, was much higher in CKD patients undergoing hemodialysis (adjusted OR, 9.74; 95% CI, 7.11-13.31). Maintenance hemodialysis patients were 2 times more likely to have gastric ulcers than duodenal ulcers, while CKD patients not on dialysis had similar risks for both. There were no significant interactions between medications and CKD status on the peptic ulcer risk. Unlike CKD patients on nonsteroidal anti-inflammatory drugs and clopidogrel, those on aspirin did not have a higher peptic ulcer risk (adjusted OR, 0.88; 95% CI, 0.44-1.77).<h4>Conclusions</h4>CKD patients have a substantially increased PUD risk, and the majority of CKD patients with PUD require hospital management. Further, peptic ulcer risk is affected by hemodialysis therapy, patient status (inpatient vs. outpatient), and ulcerogenic medications.Chih-Chia LiangChih-Hsin MuoI-Kuan WangChiz-Tzung ChangChe-Yi ChouJiung-Hsiun LiuTzung-Hai YenChiu-Ching HuangChi-Jung ChungPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e87952 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chih-Chia Liang Chih-Hsin Muo I-Kuan Wang Chiz-Tzung Chang Che-Yi Chou Jiung-Hsiun Liu Tzung-Hai Yen Chiu-Ching Huang Chi-Jung Chung Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
description	<h4>Objectives</h4>We aimed at determining peptic ulcer disease (PUD) incidence among chronic kidney disease (CKD) patients during 1998-2008, compared to patients without CKD, and at examining associations between CKD and PUD.<h4>Methods</h4>Data for 1998-2008 were extracted from the National Health Insurance Research Database in Taiwan. The annual PUD incidence (cases per thousand persons per year) was calculated separately for patients with and without CKD. Characteristics of patients with newly diagnosed PUD (n = 16322) were compared to those of a control group without PUD (n = 32644). The 2 groups were matched for age, sex, and index year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression.<h4>Results</h4>Over the 10-year period, the PUD incidence was ∼10-12 times higher in CKD patients than in those without CKD. Its incidence in elderly CKD patients increased rapidly over time. For CKD patients, most PUD events (>95%) were managed during hospitalization. Peptic ulcer risk, adjusted for all potential confounders, was much higher in CKD patients undergoing hemodialysis (adjusted OR, 9.74; 95% CI, 7.11-13.31). Maintenance hemodialysis patients were 2 times more likely to have gastric ulcers than duodenal ulcers, while CKD patients not on dialysis had similar risks for both. There were no significant interactions between medications and CKD status on the peptic ulcer risk. Unlike CKD patients on nonsteroidal anti-inflammatory drugs and clopidogrel, those on aspirin did not have a higher peptic ulcer risk (adjusted OR, 0.88; 95% CI, 0.44-1.77).<h4>Conclusions</h4>CKD patients have a substantially increased PUD risk, and the majority of CKD patients with PUD require hospital management. Further, peptic ulcer risk is affected by hemodialysis therapy, patient status (inpatient vs. outpatient), and ulcerogenic medications.
format	article
author	Chih-Chia Liang Chih-Hsin Muo I-Kuan Wang Chiz-Tzung Chang Che-Yi Chou Jiung-Hsiun Liu Tzung-Hai Yen Chiu-Ching Huang Chi-Jung Chung
author_facet	Chih-Chia Liang Chih-Hsin Muo I-Kuan Wang Chiz-Tzung Chang Che-Yi Chou Jiung-Hsiun Liu Tzung-Hai Yen Chiu-Ching Huang Chi-Jung Chung
author_sort	Chih-Chia Liang
title	Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
title_short	Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
title_full	Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
title_fullStr	Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
title_full_unstemmed	Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
title_sort	peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/5e9cda35900c4323af0d49de1585649d
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Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications.

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