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Patients undergoing hemodialysis (HD) are at excess risk for morbidity and mortality from a number of invasive procedures (Am J Cardiol 2003; 92:1160, and Surg Today 1998; 28:268). However, the risk for perforation from colonoscopy in HD patients is unknown. To examine this issue, investigators retrospectively compared incidence of perforation in 15,098 consecutive patients (1106 HD patients and 13,992 non-HD controls) who underwent colonoscopy during an 8-year period at a hospital in Japan.
Perforations occurred in five HD patients (2 of whom died) and three controls; incidence of perforations was higher in HD patients than controls (0.45% vs. 0.02%; odds ratio, 21.17; P<0.001). Regarding perforations in HD patients, two were in the cecum, …