Rectal Ulcers and Chronic Renal Failure

Excerpt

To the editor: We read with interest the report of Goldberg and coworkers ( 1 ) about rectal ulcers in patients with chronic renal failure. We recently saw a 55-year-old black man with end-stage renal disease secondary to hypertension who was evaluated for guaiac-positive stools. He had been on chronic ambulatory peritoneal dialysis for the last 2 years and had previously spent 4 years in hemodialysis.

Abdominal examination showed multiple scars, normal bowel sounds, and a peritoneal dialysis catheter. There was no tenderness or rebound. Rectal findings included guaiac-positive stools without masses or rectal prolapse. Laboratory tests showed a hemoglobin