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Hemodialysis Linked to Higher Risk of Colonic Perforation

Study suggests risk of perforation during colonoscopy significantly higher

THURSDAY, Jan. 7 (HealthDay News) -- The risk of perforation during colonoscopy is much higher in patients undergoing hemodialysis, according to a study in the January issue of Clinical Gastroenterology and Hepatology.

Norihiro Imai, M.D., and colleagues from Nagoya Kyoritsu Hospital in Japan retrospectively examined the incidence of colonic perforation in 15,098 patients who had undergone colonoscopy. Of these, 1,106 patients underwent hemodialysis, while the remaining 13,992 did not.

The researchers found that the incidence of colonic perforation was significantly higher among hemodialysis patients (0.45 versus 0.02 percent), even after controlling for possible confounding factors (odds ratio, 19.91). Examination of perforated mucosa from three hemodialysis patients and three patients who did not undergo hemodialysis showed deposition of β2-microglobulin only in the hemodialysis patients.

"There is a higher risk of colonic perforation during colonoscopy among patients who received hemodialysis compared with those who did not," Imai and colleagues conclude. "Therefore, reconsideration of the indications for colonoscopy in patients on hemodialysis is needed, especially for screening colonoscopy."

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