Is Standard Ulcer Therapy Effective in Patients with Uremia?

Patients with uremia who receive dialysis have excess risk for peptic-ulcer bleeding. High-dose intravenous proton-pump inhibitor (PPI) therapy after endoscopic therapy has been shown to reduce risk for rebleeding from high-risk peptic ulcers, but not specifically in patients with uremia.

Researchers in Taiwan evaluated the effects of endoscopic therapy followed by high-dose IV PPI therapy on bleeding peptic ulcers in 42 uremic patients who were receiving regular dialysis and 46 age- and sex-matched controls without uremia. After endoscopic therapy with epinephrine, PPI therapy consisted of a 40-mg bolus of IV omeprazole followed by continuous infusion of 40 mg every 12 hours for 3 days. Patients then received oral omeprazole (20 mg daily) f…