Prevalence of Helicobacter pylori infection in long-term hemodialysis patients

Abstract

Patients on hemodialysis often have gastrointestinal complications; however, it is unclear if Helicobacter pylori infection is present in these patients. Here we determined the prevalence of H. pylori infection in 539 Japanese hemodialysis patients by measuring serum anti-H. pylori IgG antibodies. Endoscopy was performed on 299 of these patients and the results were compared to 400 patients with normal renal function who had also undergone endoscopy and sero-testing. A second cohort of 478 dialysis patients, within the original group, was checked serologically for H. pylori infection three times over a four-year observation period. The prevalence of infection in these patients was significantly lower than in those patients with normal renal function, irrespective of the clinical outcomes. The prevalence of H. pylori infection significantly decreased as the duration of dialysis increased, particularly within the first four years following initiation of dialysis. About one-third of patients on dialysis for less than four years became serologically negative for H. pylori infection within this observation period. Our study suggests that although long-term dialysis patients have low prevalence of H. pylori, they still have significant gastroduodenal diseases, such as peptic ulcers, that require endoscopic follow-up.

Gastrointestinal Complications in Patients with Chronic Kidney Disease—A 5-Year Retrospective Study from a Tertiary Referral Center

“…However, recent consensus shows that the prevalence of H. pylori infection in chronic renal failure patients receiving peritoneal or hemodialysis to be equal or lower compared with the subjects with normal renal function in various different geographic populations irrespective of the presence/absence of gastric symptoms. [8][9][10][11] In our study, only 2 out of 30 patients with CKD (one on hemodialysis), who had OGD biopsy, showed H. pylori infection. The prevalence of infection decreases as dialysis periods progressed, in particular within the first 4 years after the start of treatment, suggesting that hemodialysis treatment, but not uremia, plays a role in the lower prevalence of H. pylori infection.…”

Gastrointestinal Evaluation in Chronic Kidney Diseases

“…Moreover, the prevalence of H. pylori infection in hemodialysis patients is significantly lower (27.5%) compared with non-hemodialysis chronic renal failure patients (56.0%), [18] and the prevalence in individuals with normal renal function, are similar with patients receiving hemodialysis treatment for less than the 1-year period [17]. These data suggest that hemodialysis treatment, but not uremia by chronic renal failure itself, plays a role in the lower prevalence of H. pylori infection.…”

“…Recently, in the investigation of 539 Japanese hemodialysis patients with treatment in a mean period of 8.4 to 0.3 years, the prevalence of H. pylori infection was reported to be 48.6%, which was significantly lower than in dyspepsia patients with normal renal function (78.5%) and individuals with the normal renal function receiving health checkup (69.4%) [17]. Moreover, the prevalence of H. pylori infection in hemodialysis patients is significantly lower (27.5%) compared with non-hemodialysis chronic renal failure patients (56.0%), [18] and the prevalence in individuals with normal renal function, are similar with patients receiving hemodialysis treatment for less than the 1-year period [17].…”

Upper Gastrointestinal Bleeding in Patients with CKD

“…Our study showed that patients with CKD and a history of UGIB had a 2-fold higher risk of UGIB. In addition, H. pylori infection has been associated with a higher risk of UGIB (23,24), and H. pylori eradication therapy decreases the risk of recurrent UGIB (25). Forty-two (1.4%) patients were receiving H. pylori eradication therapy; this therapy did not significantly affect UGIB risk.…”