Review of Helicobacter pylori Infection and Chronic Renal Failure

Abstract

Chronic renal failure patients receiving hemodialysis and continuous ambulatory peritoneal dialysis often encounter gastrointestinal troubles over their long treatment period. Helicobacter pylori infection has close association with development of peptic ulcer, gastric cancer and gastric lymphoma, and is thought to be one of the major risk factors for gastrointestinal troubles in dialysis patients. However, it is unclear whether H. pylori infection is directly associated with progression of renal dysfunction and prognosis of chronic renal failure patients. Recent consensus shows that the prevalence of H. pylori infection in chronic renal failure patients is significantly lower than in subjects with normal renal function. In the natural history of H. pylori infection in hemodialysis patients, the prevalence of infection decreases as dialysis periods progressed, in particular within the first four years after the start of treatment. However, the chance of natural eradication becomes rare for patients receiving dialysis treatment for a long time. Moreover, chronic renal failure patients with H. pylori infection have a higher incidence of gastroduodenal diseases, and therefore, are recommended to receive eradication therapies, especially for those receiving treatment for a long time and with higher risks of complication. Intensive endoscopic check-ups for the prevention of gastrointestinal events and the discovery of peptic ulcer and neoplastic diseases at an early phase may be required.

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

“…In this study, which spans over a 5 year period, 30 out of 38 patients with CKD had significant findings on upper endoscopy and were biopsied. Predominant biopsy findings included erosive gastritis (13), ulcerative esophagitis (7), esophageal candidiasis (8), and duodenitis/duodenal ulcerations (7). None of these patients were documented to be on any gastric irritant drugs.…”

“…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.…”

The Relationship of Helicobacter Pylori Infection with Demographic, Socioeconomic and Environmental Factors: Ankara Hospital Experience

“…Ancak güncel çalışmalar HP prevalansının normal renal fonksiyonu olan hastalara kıyasla KBY'li hastalarda oldukça düşük olduğunu göster-mektedir 28 . Çalışmamızda az sayıda KBY'li hasta bulunmakta idi ancak yine de literatür ile uyumlu olarak olduğu yerlerde, kalabalık yaşam koşullarında prevalansın sık olması hastalığın fekal-oral yol ile bulaştığı-nı düşündürmektedir.…”

Helicobacter pylori: Effect of coexisting diseases and update on treatment regimens

“…In addition, a higher recurrent peptic ulcer rate was noted after successful H. pylori eradication in H. pylori-infected ESRD patients. Sugimoto et al [20,51] reported that initiating hemodialysis treatment triggers a decrease in the prevalence of H. pylori infection. Moreover, receiving a maximum of 4 years of dialysis treatment has naturally cured H. pylori infection, thus supporting the practice of administering eradication therapy to H. pylori-infected dialysis patients, particularly those receiving dialysis for 5 years or more.…”