Predictors of Recurrent AVM-Related Bleeding in Patients With Advanced CKD Receiving Balloon Enteroscopy
Document Type
Article
Abstract
Introduction: Arteriovenous malformations (AVMs) are a frequent cause of small bowel bleeding that may require investigation and intervention by balloon-assisted enteroscopy (BAE). For patients with Chronic Kidney Disease (CKD) at advanced stages, including End-Stage Renal Disease (ESRD), these small bowel lesions can be recurrent and prompt healthcare encounters for medical and endoscopic intervention. Within a population of patients with advanced CKD seeking care at a tertiary care center, we sought to assess if there are clinical features that may predict a risk of recurrent bleeding.
Methods: We performed a retrospective review of an endoscopic database. We included patients with advanced CKD with known AVMs who had received endoscopic intervention involving at least 1 antegrade BAE. The primary outcome was to identify predictors of recurrent AVM-related bleeding. Patients with non-AVM lesions detected during BAE were excluded. Statistical analysis was conducted in RStudio.
Results: A total of 47 patients (55% men, 45% women) were included. Recurrent bleeding occurred in 23 patients (49%). No significant associations were revealed amongst gender (RR 1.13, 95% confidence interval [CI] 0.63-2.03; P=0.67) and clinical features of antithrombotic use (RR 1.41, 95%CI 0.82-2.42; P=0.24), AVM bleeding on BAE (RR 0.64, 95%CI 0.38-1.08; P=0.12), inpatient versus outpatient BAE (RR 1.34, 95%CI 0.75-2.39; P=0.0.31), overt versus occult bleeding presentation (RR 1.05, 95%CI 0.60-1.83; P=0.87), and single versus double BAE (RR 0.68, 95%CI 0.38-1.24; P=0.19) and risk of recurrent AVM-related bleeding.
Conclusion: Despite prior studies indicating an association between the aforementioned clinical features and risk of recurrent bleeding or BAE, this was not demonstrated in our study involving patients with advanced CKD.
First Page
S1350
DOI
10.14309/01.ajg.0000956916.92708.b6
Publication Date
10-1-2023
Recommended Citation
Do KO, Issac A, Tran CN, Biermann M, Youngblood A, Spandorfer A, Desai N, Abdalla A, Khare AP, Vachaparambil C, Willingham F. S1819 Predictors of Recurrent AVM-Related Bleeding in Patients With Advanced CKD Receiving Balloon Enteroscopy. Official journal of the American College of Gastroenterology| ACG. 2023 Oct 1;118(10S):S1350.