RT Journal
A1 Vance VK
T1 USe of upper gastrointestinal endoscopy
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD August 1
VO 139
IS 8
SP 944
OP 944
DO 10.1001/archinte.1979.03630450086032
UL http://dx.doi.org/10.1001/archinte.1979.03630450086032
AB To the Editor.— 
    The article by Margolis et al in the Archives (138:1214-1217, 1978) reporting endoscopically identifiable gastroduodenal disease in 83% of patients undergoing hemodialysis for chronic renal failure was very instructive. However, I fail to understand the basis of their recommendation "that patients with symptomatic or roentgenographic upper gastrointestinal disease... undergo further evaluation with upper gastrointestinal endoscopy." I question whether patients without symptoms (60% in their series) should be subjected to gastrointestinal roentgenography and I particularly question the value of endoscopy if, as they state, only 17% of patients will have normal findings.It is ironic that this article, advocating an expensive (and in my estimation irrational) procedure should follow that of Bartha and Nugent (138:1211-1213, 1978) who conclude that "chest roentgenograms and ECG's cannot be defended on the basis of their contribution to the workup of hypertension." I wonder how Margolis et al can possibly justify endoscopy in