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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Gastrointestinal (GI) bleeding is a significant complication among patients with chronic kidney disease (CKD), often leading to increased morbidity and mortality. The blood urea nitrogen (BUN)-to-creatinine ratio has been proposed as a potential predictor for GI bleeding, given its association with uremic platelet dysfunction and increased bleeding tendency. Several studies found a significant association between BUN:Creatinine ratio and gastrointestinal bleeding, however, its utility among patients with renal impairment has not been studied. This study aims to assess the predictive value of the BUN-to-creatinine ratio for GI bleeding in CKD patients.
A retrospective cohort study was conducted on 397 CKD patients admitted in a tertiary hospital between January 1, 2021, and December 31, 2023. Data on age, gender, CKD stage, dialysis status, comorbidities, medication, outcomes, and laboratory values, including BUN-to-creatinine ratio, were analyzed. Statistical analysis using receiver operating characteristic (ROC) curve analysis was done to evaluate the predictive value of the BUN-to-creatinine ratio for GI bleeding.
GI bleeding occurred in 110 (28%) of the patients. It was significantly associated with lower systolic blood pressure, anemia, thrombocytopenia, and hypoalbuminemia. Blood transfusions were substantially more frequent in patients with GI bleeding (80.91% vs. 50.17%, p < 0.001), and mortality was significantly higher (31.48% vs. 11.07%, p < 0.001). Endoscopy was performed in 35 patients, revealing the most common lesions as erosive gastropathy (42.85%) and gastric ulcers (34.28%). The BUN-to-creatinine ratio was significantly higher in patients with GI bleeding (16.33, IQR: 12.86 to 22.96) compared to those without bleeding (11.1, IQR: 10.36 to 14.32), p < 0.001. A BUN-to-creatinine ratio threshold of 11.6343 yielded a sensitivity of 68.18%, a specificity of 72.10%, and an AUC of 0.7916, indicating moderate predictive accuracy. Among non-dialysis patients, the median BUN-to-creatinine ratio was significantly higher than in dialysis patients (16.33 vs. 11.1, p < 0.001), highlighting the importance of renal function in the predictive value of this marker. Notably, the negative predictive value (NPV) of the BUN:Creatinine ratio was high at 85.04%, suggesting that a lower ratio of <11.6343 is effective in ruling out the presence of GIB in CKD patients, especially those not undergoing dialysis.
The BUN-to-creatinine ratio is a moderately accurate predictor of GI bleeding in CKD patients, particularly among non-dialysis patients. Its predictive value is enhanced by considering other clinical factors such as comorbidities and dialysis status. While it shows moderate diagnostic performance overall, its high negative predictive value indicates that a low BUN:Creatinine ratio <11.6343 can effectively exclude the presence of GIB, facilitating more efficient clinical decision-making. This tool, particularly useful in non-dialysis patients, should be integrated into a broader diagnostic strategy to enhance early detection and management of GIB.
