The Japanese Journal of Clinical Dialysis Vol.18 No.12(2-3-2)

Theme Gastrointestinal Complications in Dialysis Patients
Title Ischemic colitis in hemodialysis patients
Publish Date 2002/11
Author Masayoshi Kajimura First Department of Medicine, Hamamatsu University School of Medicine
Author Akira Hishida First Department of Medicine, Hamamatsu University School of Medicine
[ Summary ] Hemodialysis patients are considered to belong to a high risk group of those having ischemic colitis, because the patients usually have several underlying diseases causing a decrease in mucosal circulation in the colon, including hypertension, diabetes mellitus, arteriosclerosis and congestive heart failure. In addition, both hemodialysis related amyloidosis and severe constipation in patients receiving longterm hemodialysis may exacerbate impairment of colonic mucosal circulation. Ischemic colitis in patients receiving hemodialysis occurs mainly in the right colon and is often severe, requiring surgical procedures. Clinical symptoms frequently occur during or immediately after hemodialysis. Since severe forms of ischemic colitis have poor prognoses, early diagnosis is very important. In addition to several modalities of abdominal imaging, measurement of erythrocyte sedimentation rates and/or CRP is useful for a prompt diagnosis of the severe form.
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