[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-452624-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-452624-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","gastrointestinal-bleeding-due-to-angiodysplasia-in-patients-with-ckd","Gastrointestinal Bleeding Due to Angiodysplasia in Patients with CKD","","Angiodysplasia is a major cause of acute and chronic gastrointestinal bleeding, ranging from overt hemorrhage to occult blood loss and iron deficiency anemia. In advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD), bleeding risk increases with disease duration and severity, influenced by multifactorial mechanisms such as chronic mucosal hypoxia, uremia-related platelet dysfunction, and frequent anticoagulation. Endoscopy is central for diagnosis and management but lesions can be missed, especially in the small bowel, and patients with CKD/ESKD often receive delayed or less frequent evaluations.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/gastrointestinal-bleeding-due-to-angiodysplasia-in-patients-with-ckd/452624/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/gastrointestinal-bleeding-due-to-angiodysplasia-in-patients-with-ckd/452624.png","ImageObject",300,407,{"name":42,"@type":43},"dhado","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why does angiodysplasia lead to gastrointestinal bleeding in CKD and ESKD?","Question",{"text":63,"@type":64},"Angiodysplasia can cause bleeding throughout the GI tract. In CKD/ESKD, multifactorial mechanisms such as chronic mucosal hypoxia and uremia-related platelet dysfunction increase bleeding risk, and anticoagulation often makes bleeding more pronounced.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Where are angiodysplasia lesions most likely to be found in patients with CKD?",{"text":68,"@type":64},"Angiodysplasias are most frequently found in the jejunum in patients with CKD. Lesions can also be missed on endoscopy, particularly in the small bowel due to limited visualization.",{"name":70,"@type":61,"acceptedAnswer":71},"What factors affect diagnosis and management of GI bleeding in advanced CKD/ESKD patients?",{"text":72,"@type":64},"Patients with advanced CKD/ESKD are less likely to receive endoscopic assessments and may have procedures performed more than 48 hours after admission, creating delays. Subtle or nonspecific symptoms can also cause anemia to be attributed to chronic disease rather than active bleeding.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},452624,1790780455,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":97,"preview_page_count":4},5909893218464,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Editorial  \nGastrointestinal Bleeding Due to Angiodysplasia in Patients with CKD  \nMaria L. Gonzalez Suarez   \nKidney360 6: 1641–1642, 2025. doi: [https://doi.org/10.34067/KID.0000000994](https://doi.org/10.34067/KID.0000000994)  \nAngiodysplasia is an important cause of acute and chronic gastrointestinal (GI) bleeding.1 It can occur throughout the GI tract, more frequently seen in the cecum and right colon, but may also be found in small bowel and stomach. Clinical presentation ranges from overt bleeding to occult blood loss or subtle iron deficiency anemia, often resulting in recurrent bleeding over weeks or months, or persistent iron deficiency despite iron supplementation.2  \nAngiodysplasia has been described as a common type of GI bleeding requiring hospitalization in patients with advanced CKD.3,4 Pathogenesis is multifactorial, including chronic mucosal hypoxia, vascular degeneration, uremiarelated platelet dysfunction, which increase the risk of bleeding.5 In addition, anticoagulation, commonly used in this population, makes bleeding more pronounced. The prevalence and risk of bleeding increase with the length and severity of renal disease, especially with the vintage of patients on hemodialysis.6  \nEndoscopy plays a central role in the diagnosis and management of angiodysplasia-associated GI bleeding (AGIB); however, lesions can sometimes be missed,2 particularly in the small bowel because of lack of visualization. In patients with CKD, angiodysplasias are most frequently found in the jejunum.4 In addition to the difficult location of angiodysplasias in this population, Garg et al. described that patients with advanced CKD and ESKD are less likely to receive endoscopic assessments, despite their increased mortality risk.7  \nTariq et al.8 examined the US Nationwide Inpatient Sample (NIS) database from 2009 to 2014, and demonstrated an increasing trend of AGIB in patients with ESKD, with elevated risk factors linked to advanced age, Black race, hypertension, and smoking. Individuals aged 75 and older were particularly at higher risk. The likelihood of AGIB was significantly higher among hospitalizations of Black patients.  \nRecently, He et al.9 conducted a retrospective study using the NIS database from 2016 to 2019 to evaluate inpatient outcomes of all-cause GI bleeding in patients with advanced CKD, ESKD, and kidney transplant recipients, compared with those without CKD. They found that nonvariceal upper GI bleeding was the most common cause of GI bleeding in all patients (38.7%) . Among patients with advanced CKD, unspecified GI bleeding was most frequent, followed by nonvariceal GI bleed. After excluding unspecified gastrointestinal bleeding, the main causes were gastric/duodenal bleeding, angiodysplasia, and diverticular bleeding. Notably, patients with ESKD were less likely to undergo an endoscopy, and among those who did, the procedure was usually performed more than 48 hours after admission, showing a delay in diagnosis and management for this population. By contrast, kidney transplant recipients received similar management to patients without CKD. Several factors may contribute to these disparities, including the greater clinical complexity and higher comorbidity burden inpatients with ESKD, which can increase the procedural risk. In addition, delayed recognition of GI bleeding may occur because of subtle or nonspecific symptoms, with anemia often attributed to chronic disease rather than active bleeding.  \nIn this issue, He et al.10 conducted a retrospective cohort study of using the 2022 NIS database and the Nationwide Readmissions Database to evaluate the incidence, outcomes, and readmissions associated with AGIB in patients with CKD. International Classification of Diseases-10 clinical modification codes were used to identify adult patients hospitalized with AGIB, and they were stratified into patients with no CKD, early CKD (stage 3), advanced CKD (stage 4 and stage 5 not on dialysis), kidney failure (KF, ESKD, or CK","cbCaikrODBl9OfKE","https://ap.wps.com/l/cbCaikrODBl9OfKE","pdf",166794,"English","# Angiodysplasia and GI bleeding in CKD\n## Clinical features and risk mechanisms\n## Diagnostic challenges and endoscopy limitations\n## Evidence from national inpatient datasets\n## Incidence, outcomes, mortality, and readmission in CKD","[{\"question\":\"Why does angiodysplasia lead to gastrointestinal bleeding in CKD and ESKD?\",\"answer\":\"Angiodysplasia can cause bleeding throughout the GI tract. In CKD/ESKD, multifactorial mechanisms such as chronic mucosal hypoxia and uremia-related platelet dysfunction increase bleeding risk, and anticoagulation often makes bleeding more pronounced.\"},{\"question\":\"Where are angiodysplasia lesions most likely to be found in patients with CKD?\",\"answer\":\"Angiodysplasias are most frequently found in the jejunum in patients with CKD. Lesions can also be missed on endoscopy, particularly in the small bowel due to limited visualization.\"},{\"question\":\"What factors affect diagnosis and management of GI bleeding in advanced CKD/ESKD patients?\",\"answer\":\"Patients with advanced CKD/ESKD are less likely to receive endoscopic assessments and may have procedures performed more than 48 hours after admission, creating delays. Subtle or nonspecific symptoms can also cause anemia to be attributed to chronic disease rather than active bleeding.\"}]","Gastrointestinal Bleeding Due to Angiodysplasia in Patients with CKD | PDF",1790737492]