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      Helicobacter pylori in Patients Receiving Long-Term Dialysis

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          Background: Helicobacter pylori (H. pylori) is considered to cause gastritis and gastric ulcer. In dialysis patients, digestive tract hemorrhage is sometimes fatal. However, in regard to H. pylori infection in patients with end-stage renal disease (ESRD), many issues remain to be clarified. Methods: This study included 76 symptom-free patients with ESRD. The subjects consisted of 25 patients with chronic renal failure who had not received dialysis and 51 patients receiving dialysis. On upper digestive tract endoscopy, specimens were taken for analysis of H. pylori. Urease test, culture, and microscopy were performed. Results: In non-dialysed patients, the prevalence of H. pylori-positive patients was 56.0%. In dialysed patients, the percentage was significantly lower (27.5%). In dialysed patients, the mean duration of dialysis was 8.1 ± 7.5 months (mean ± SD) in H. pylori-positive patients and 56.2 ± 60.9 months (mean ± SD) in H. pylori-negative patients (p < 0.001). 11 of 13 non-dialysed patients with chronic gastritis were positive for H. pylori. However, only 5 of 24 dialysed patients were positive for H. pylori infection. Conclusions: Long-term dialysis decreased the prevalence of H. pylori. The reduction of gastric acid secretion related to chronic gastritis may be involved.

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          Helicobacter pylori antibodies in hemodialysis patients and renal transplant recipients.

           F Besisik,  M Sever,  E Ark (1999)
          In this cross-sectional, controlled study, Helicobacter pylori (H. pylori) infection, a probable factor in the development of gastrointestinal problems, was investigated in dialysis patients and renal transplant recipients. Forty-seven dialysis patients (22 male, 25 female, mean age of 36.6 +/- 15 yr (range 18-83 yr)), 57 renal transplant recipients (39 male, 18 female, mean age of 36.8 +/- 10 yr (range 19-60 yr)) and 55 healthy individuals (34 male, 21 female, mean age of 33.4 +/- 9.6 yr (range 21-58 yr)) were included and no significant difference was found in the study groups. The mean time spent on dialysis in the hemodialysis group was 32.5 +/- 27.7 months (range 1-100 months). H. pylori antibodies were detected in 22 of 57 (38.6%) patients in the transplantation group, 31 of 47 (65.9%) patients in the dialysis group and 39 of 55 (72.5%) in the control group. No correlation was found between H. pylori infection and age, sex, primary disease, frequency of dialysis, duration and type of transplantation and the immunosuppressive therapy. However, patients with H. pylori antibodies spent a shorter time on dialysis compared to patients without the antibodies (26.6 +/- 23.5 vs 44.1 +/- 32.1 months, p = 0.038). The frequency of H. pylori infection in the transplantation group was significantly lower than the control and dialysis groups (p < 0.01). This finding may be explained on the basis of decreased humoral antibody response to H. pylori infection, secondary to immunosuppressive therapy rather than decreased incidence of infection in the transplantation group. Finally, we concluded that the value of the serological test for diagnosis of H. pylori infection should be interpreted cautiously in these patient groups.

            Author and article information

            Am J Nephrol
            American Journal of Nephrology
            S. Karger AG
            December 2002
            07 October 2002
            : 22
            : 5-6
            : 468-472
            Departments of aNephrology, bInternal Medicine, and cSurgery, Moriguchi Keijinkai Hospital, Moriguchi, and dDepartment of Urology, Osaka Medical College, Osaka, Japan
            65278 Am J Nephrol 2002;22:468–472
            © 2002 S. Karger AG, Basel

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            Page count
            Figures: 2, Tables: 2, References: 15, Pages: 5
            Self URI (application/pdf):
            Clinical Study

            Cardiovascular Medicine, Nephrology

            Prevalence, Helicobacter pylori, Renal dysfunction, Dialysis


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