Abstract
Routine endoscopic examinations of the lower digestive tract were performed in 46 patients over 40 years of age on maintenance hemodialysis. We found one patient (2.2%) with rectal cancer, and 11 patients (23.9%, 23 lesions) with colorectal polyps. A rectal cancer patient (well-differentiated adenocarcinoma, Borrmann 2 type) underwent Miles' operation. All 23 polyps in the 11 patients were tubular adenomas. Four of the 11 patients underwent endoscopic polypectomy. We comparatively analyzed various parameters in the 11 patients with colorectal polyps (group 1) and 34 patients without them (group 2).
Hematocrit levels were significantly lower in group 1 than in group 2 (group 1:26.4%, group 2:29.4%). Immunological fecal occult blood tests (IFOBTs) were positive more frequently in group 1 than in group 2. We therefore suspected that patients with colorectal polyps had chronic bleeding from their polyps. We divided the patients into 4 groups according to the annual frequency of positive IFOBT: 0, 1, 2, and more than 3 times, and studied the relationship between the frequency of positive IFOBT and the prevalence rate of colorectal polyps. The prevalence rates of colorectal polyps in the individual groups were 0, 25, 38, and 100%, respectively. Relationship was found between them.
We concluded that the prevalence of colorectal polyps in patients on maintenance hemodialysis is higher than in normal populations, and when we consider bleeding from the polyps and the possibility of carcinogenesis in adenomas, endoscopic examination of the lower digestive tract should be performed routinely. Monthly IFOBT tests were very useful in screening for colorectal polyps.
