Clinical Features of Gastroduodenal Ulcers in Kidney Transplant Patients
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- Kondo Masahiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Torisu Takehiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Ihara Yutaro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Kawasaki Keisuke
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Umeno Junji
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Kawatoko Shinichiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Japan
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- Tsuchimoto Akihiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Nakano Toshiaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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- Okabe Yasuhiro
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
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- Kitazono Takanari
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
説明
<p>Objective The risk of developing peptic ulcers and gastrointestinal bleeding is high in patients with chronic kidney disease (CKD). Whether or not kidney transplant patients, who are treated with multiple medications, including immunosuppressive drugs, are at an increased risk of developing peptic ulcers is unclear. </p><p>Methods In this retrospective study, we compared the clinical and endoscopic features of gastroduodenal ulcers between kidney transplant patients and CKD patients. The subjects underwent upper gastrointestinal endoscopy between January 2015 and March 2021. </p><p>Results Gastroduodenal ulcers were observed more frequently (6.5%) in kidney transplant patients than in CKD patients (2.1%) (p=0.026). Due in part to the lower median age in the kidney transplant ulcer group than in the CKD ulcer group (59 vs. 70 years old, p=0.016), the rates of atrophic gastritis and Helicobacter pylori infection were also lower in the kidney transplant ulcer group than in the CKD ulcer group. Significantly more kidney transplant patients were treated with acid secretion inhibitors than CKD ulcer patients (100% vs. 34.8%, p=0.0005). Peptic ulcers were observed frequently in kidney transplant patients, even though common risk factors for gastroduodenal ulcers other than immunosuppressive drugs were few. All kidney transplant patients were taking immunosuppressive medications, and tacrolimus, mycophenolate mofetil, and methylprednisolone were taken more frequently than others. </p><p>Conclusion Kidney transplant patients have a high risk of developing gastroduodenal ulcers. All kidney transplant patients take immunosuppressive medications, so there may be an association between immunosuppressive medications and gastroduodenal ulcer development. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 62 (23), 3437-3443, 2023-12-01
一般社団法人 日本内科学会