Introduction: Gastrointestinal bleeding (GIB) is more common in patients with end stage renal disease (ESRD) and is associated with higher mortality than in the general population. There are limited data regarding the occurrence of upper GIB in dialysis patients in our locality. So, we aimed to identify upper GIT lesions by endoscopy in ESRD patients with occult GIT bleeding.
Patients and methods: Highly sensitive guaiac-based faecal occult blood Hemoccult SENSA test (FOBT) was performed on stool specimens of 100 ESRD patients with upper GI symptoms; 36 with advanced renal failure prior to dialysis (CRF), 64 on maintenance hemodialysis (HD). None of the patients had overt gastrointestinal bleeding prior to participation in the study. Patients with positive FOBT underwent diagnostic upper GI endoscopy.
Results: Twenty eight patients had positive guaiac-based FOBT where the majority was HD patients (71.4%). 26 patients with positive FOBT had UGI lesions with positive predictive value of 92.8%. Gastric lesions (42.9%) were the most common lesions followed by duodenal lesions and angiodysplasia (21.3% for each).
Conclusion: Fecal occult blood test can be used routinely as a simple and non-invasive screening tool for early detection of UGIB in ESRD patients. The positive test should be followed by additional diagnostic procedures to identify the cause of occult bleeding.
Keywords: Upper gastrointestinal bleeding; End stage renal disease; fecal occult blood; Hemoccult Sensa