Publication:

Gastric adenocarcinoma due to H. Pylori infection on patient with chronic kidney disease on hemodialysis

A 53-year-old Male was admitted to our emergency department presenting with severe anemia (Hb 6.9 gr/dl) with a history of chronic kidney disease on routine hemodialysis twice a week and insulin-dependent type 2 diabetes. He was diagnosed with gastric adenocarcinoma after biopsy sample acquired from endoscopy confirmed by pathologist. The patient also has a positive HPSA test result. He was given rapid insulin 3 times daily and long-acting insulin once daily, continued routine hemodialysis and planned to do partial gastrectomy after recommended serum-creatinine level and minimum hemoglobin level are reached. We will take into consideration the routine use of anti-platelets and anti-coagulants during hemodialysis and how it will affect our decision to do surgery. Currently the patient still discusses the option of surgery even though it has been suggested by the digestive surgeon. In conclusion, we are discussing the difficulties of managing patient with gastric adenocarcinoma caused by H. pylori infection with chronic kidney disease and diabetes as the aggravating factors, including the use of routine medication and managing the blood sugar.