Hye Kyung Hyun, Nak-Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae-Hyun Yoo, Shin-Wook Kang, Hae-Ryong Yun, Cheal Wung Huh
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引用次数: 0
Abstract
Background: The association between delayed post-polypectomy bleeding and chronic kidney disease remains unclear.
Objective: This study investigated whether patients with chronic kidney disease are at an increased risk of delayed post-polypectomy bleeding.
Methods: This cohort study included patients who underwent colonoscopy and polypectomy in Korea between 2005 and 2022. We assessed various covariates, including patient-, polyp-, and procedure-related factors, using propensity score matching and inverse probability of treatment weighting to determine the impact of chronic kidney disease on delayed post-polypectomy bleeding risk.
Results: Out of 21,562 patients, 16,591 with 41,014 polyps were included in the analysis. Of these, 2057 (12.4%) had chronic kidney disease, with 894 in early-stage (stages 1 and 2) and 1163 in advanced-stage (stages 3-5). There were 14,534 individuals without chronic kidney disease. After propensity score matching, the risk of delayed post-polypectomy bleeding in patients with chronic kidney disease was significantly higher than that in the non-chronic kidney disease group (OR 1.80, CI 1.12-2.89, p = 0.01). The risk increased with chronic kidney disease stage (OR 2.38, 95% CI 1.01-5.64 for early stage; OR 2.80, 95% CI 1.20-6.51 for advanced stage, all p < 0.05). The results remained robust after inverse probability analysis.
Conclusions: Chronic kidney disease is an independent risk factor for delayed post-polypectomy bleeding, even in the early stages. The risk correlates with the chronic kidney disease stage. Meticulous attention is imperative during polypectomy for all patients with chronic kidney disease, including those in the early stages.
背景：息肉切除术后迟发性出血与慢性肾脏疾病之间的关系尚不清楚。目的：本研究探讨慢性肾病患者息肉切除术后迟发性出血的风险是否增加。方法：本队列研究包括2005年至2022年间在韩国接受结肠镜检查和息肉切除术的患者。我们评估了各种协变量，包括患者、息肉和手术相关因素，使用倾向评分匹配和治疗加权逆概率来确定慢性肾脏疾病对息肉切除术后延迟出血风险的影响。结果：在21,562例患者中，16,591例41,014例息肉被纳入分析。其中，2057例（12.4%）患有慢性肾脏疾病，894例为早期（1期和2期），1163例为晚期（3-5期）。14534人没有慢性肾脏疾病。经倾向评分匹配后，慢性肾病患者息肉切除后迟发性出血的风险显著高于非慢性肾病组（OR 1.80, CI 1.12-2.89, p = 0.01）。随着慢性肾脏疾病的分期，风险增加(早期OR 2.38, 95% CI 1.01-5.64；结论：慢性肾脏疾病是息肉切除术后迟发性出血的独立危险因素，即使在早期也是如此。风险与慢性肾脏疾病阶段有关。在所有慢性肾脏疾病患者，包括早期患者的息肉切除术中，细致的关注是必不可少的。
期刊介绍：
United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.
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