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      Association between Helicobacter pylori and end-stage renal disease: A meta-analysis

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          To investigate the prevalence and association of Helicobacter pylori ( H. pylori) with end-stage renal disease (ESRD).


          SA comprehensive literature search was completed from inception until October 2016. Studies that reported prevalence, relative risks, odd ratios, hazard ratios or standardized incidence ratio of H. pylori among ESRD patients were included. Participants without H. pylori were used as comparators to assess the association between H. pylori infection and ESRD. Pooled risk ratios and 95%CI was calculated using a random-effect model. Adjusted point estimates from each study were combined by the generic inverse variance method of DerSimonian and Laird.


          Of 4546 relevant studies, thirty-seven observational studies met all inclusion criteria. Thirty-five cross-sectional studies were included in the analyses to assess the prevalence and association of H. pylori with ESRD. The estimated prevalence of H. pylori among ESRD patients was 44% (95%CI: 40%-49%). The pooled RR of H. pylori in patients with ESRD was 0.77 (95%CI: 0.59-1.00) when compared with the patients without ESRD. Subgroup analysis showed significantly reduced risk of H. pylori in adult ESRD patients with pooled RR of 0.71 (95%CI: 0.55-0.94). The data on the risk of ESRD in patients with H. pylori were limited. Two cohort studies were included to assess the risk of ESRD in patients with H. pylori. The pooled risk RR of ESRD in patients with H. pylori was 0.61 (95%CI: 0.03-12.20).


          The estimated prevalence of H. pylori in ESRD patients is 44%. Our meta-analysis demonstrates a decreased risk of H. pylori in adult ESRD patients.

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          Most cited references 53

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          Effect of interleukin 1 polymorphisms on gastric mucosal interleukin 1beta production in Helicobacter pylori infection.

          Although epidemiological studies suggest that interleukin (IL)-1 genetic polymorphisms are involved in Helicobacter pylori-related gastric carcinogenesis, the data are conflicting regarding the effects of these polymorphisms on IL-1beta production. IL-1B-511 polymorphism was genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism, and IL-1RN variable number of tandem repeats was determined by PCR. Mucosal IL-1beta levels were measured by enzyme-linked immunosorbent assay. To determine which factors influence mucosal IL-1beta levels, gastric inflammation, and atrophy, multiple regression analyses were performed. We studied 117 H. pylori-infected Japanese patients. Carriers of the IL-1B-511T/T genotype or IL-1RN*2 allele had higher mucosal IL-1beta levels than noncarriers (partial regression coefficient [PRC] +/- SE), TT versus CC: 37.6 +/- 6 [antrum] and 32.1 +/- 6 [corpus] pg/mg protein (P < 0.001 for each), *1/*2 versus *1/*1: 24 +/- 8 [antrum] (P <0.01) and 36.5 +/- 7 [corpus] (P <0.001). Simultaneous carriers of IL-1B-511T/T genotype and IL-1RN*2 allele had the highest IL-1beta levels (82.9 +/- 12 [antrum] and 87.2 +/- 11 [corpus]) and showed a synergistic effect between 2 loci. The *1/*2 carriers were closely related to atrophy (PRC +/- SE; 0.87 +/- 0.4 [antrum] and 0.93 +/- 0.4 [corpus], P < 0.05), whereas being a carrier of the -511T/T genotype was related to severe gastric inflammation. IL-1 genetic polymorphisms influenced H. pylori-related gastric mucosal IL-1beta levels and were related to gastric inflammation and atrophy, factors thought to be important in gastric carcinogenesis.
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            Transmission and epidemiology of Helicobacter pylori.

             Kyle Cave (1996)
            Helicobacter pylori is one of the most common bacterial infections worldwide. However, the majority of those infected do not develop clinical manifestations of disease. This review discusses the epidemiology of the organism in terms of incidence and prevalence, the presumed means of transmission from person to person, and how typing of the organism has helped the epidemiologist. The epidemiology of disorders that are associated with H. pylori is also discussed.
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              Gastro-duodenal lesions and Helicobacter pylori infection in uremic patients and renal transplant recipients.

              Upper gastrointestinal (UGI) symptoms are common in uremic patients, and higher serum levels of urea have been suggested to be related to Helicobacter pylori (HP) colonization and UGI mucosal inflammation. The aim of this study was to compare HP infection and UGI endoscopic findings between uremic patients, renal transplant (RT) recipients, and controls. A total of 474 subjects (71 chronic renal failure [CRF], 73 hemodialysis [HD], 25 Tx, and 305 controls) from Baqyiatallah Hospital, Tehran, Iran were recruited between April 2002 and March 2004 for evaluation of dyspepsia, excluding those receiving any HP-eradication therapy. All subjects were examined for esophagus, stomach and duodenum mucosa, and infection with HP on 2 distinct tissue samples of the anthral region. Four groups of subjects (mean +/- 2 se; age, 45 +/- 1.6 years; 62.9% male) were studied. Duodenal ulcer in the uremic patients (CRF, 16.1%; HD, 13.7%) was more common than that in the RT-recipients (8%) and controls (6.5%); P=.038. Erosive gastritis and duodenal bulb deformity were also more common in the uremic subjects (CRF, 23.9%, 36.9%; HD, 30.1%, 20.5%, respectively) than those in the other subjects (RT recipients, 16%, 8%; controls, 8.2%; 0%, respectively); P<.001. HP infection was found to be higher in the uremic patients (CRF, 66.2%; HD, 63%) than in the RT recipients (40%) and controls (34.8%); P<.001. Higher rates of gastric and duodenal mucosal lesions and HP infection in the uremic patients in comparison with the subjects with normal renal function may have resulted from higher serum levels of urea, anemia, and fluctuations in the gastric blood supply in the CRF and HD patients. However, more tenable evidence from controlled trials is required for the eradication of HP in all uremic patients and transplantation candidates.

                Author and article information

                World J Gastroenterol
                World J. Gastroenterol
                World Journal of Gastroenterology
                Baishideng Publishing Group Inc
                28 February 2017
                28 February 2017
                : 23
                : 8
                : 1497-1506
                Karn Wijarnpreecha, Charat Thongprayoon, Ridhmi Rajapakse, Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, United States
                Pitchaphon Nissaisorakarn, Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, United States
                Natasorn Lekuthai, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
                Veeravich Jaruvongvanich, Department of Medicine, University of Hawaii, Honolulu, HI 96822, United States
                Kiran Nakkala, Cape Fear Center for Digestive Diseases, P.A., Fayetteville, NC 28312, United States
                Wisit Cheungpasitporn, Division of Nephrology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
                Author notes

                Author contributions: Cheungpasitporn W contributed to conception and design of the study, and critical revision; Wijarnpreecha K, Thongprayoon C, Nissaisorakarn P and Jaruvongvanich V contributed to acquisition of data, Wijarnpreecha K, Nissaisorakarn P, Lekuthai N, Jaruvongvanich V, Nakkala K and Rajapakse R interpreted the data; Wijarnpreecha K and Thongprayoon C drafted the article; Lekuthai N, Nakkala K and Rajapakse R revised the article; all authors approved the final version.

                Correspondence to: Wisit Cheungpasitporn, MD, Division of Nephrology, Department of Internal Medicine, Mayo Clinic, 200 First street SW, Rochester, MN 55905, United States. wcheungpasitporn@

                Telephone: +1-507-2848450 Fax: +1-507-2667891

                ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.



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