Peritoneal dialysis and colonic angiodysplasia bleeding: Are they connected?. Issue 1 (May 2018)

• Record Type: Journal Article
• Authors: Riva, Hilary; Mangano, Stefano; Minoretti, Claudio; Giannini, Olivier; Bonforte, Giuseppe
• Is Part Of: Nephrology @ point of care. Volume 4:Issue 1(2018)
• Publication Date: 2018-05
• Subjects: Peritoneal dialysis -- colonic angiodysplasia -- peritoneal dialysis indication; Nephrology -- Periodicals; 616.61
• DOI: 10.1177/2059300718761286
• Languages: English
• ISSNs: 2059-3007

Abstract

Angiodysplasia is the most common gastrointestinal vascular lesion and a frequent cause of hidden bleeding. Here, we present the case of two patients with severe colonic angiodysplasia-related anemia on peritoneal dialysis. Several attempts to reduce gastrointestinal bleeding have been made without a definitive solution. For these patients, peritoneal dialysis was considered better than hemodialysis because anticoagulation is not needed. However, later the switch from peritoneal dialysis to hemodialysis has been made and an improvement of anemia, due to the cessation of the gastrointestinal bleeding, has been noted. Chronic kidney disease patients are at high risk of bleeding for several reasons. Our hypothesis is that filling the abdomen with peritoneal dialysis solution increases the peritoneal pressure, worsening the colonic venous blood flow and probably peritoneal dialysis with this mechanism sustains the angiodysplasia bleeding. Our conclusions are that peritoneal dialysis indication and peritoneal dialysis prescription should be evaluated with attention in patient with colonic angiodysplasia for its uncertain effect on bleeding.