Association betweenHelicobacter pyloriand end-stage renal disease: A meta-analysis

Abstract

AIMTo investigate the prevalence and association of Helicobacter pylori (H. pylori) with end-stage renal disease (ESRD).METHODSSA 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.RESULTSOf 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).CONCLUSIONThe estimated prevalence of H. pylori in ESRD patients is 44%. Our meta-analysis demonstrates a decreased risk of H. pylori in adult ESRD patients.

Association betweenH. pyloriinfection and health Outcomes: an umbrella review of systematic reviews and meta-analyses

“…Our confidence level in the following was low: H. pylori infection is associated with a decreased risk of oesophageal adenocarcinoma in the overall population,18 colorectal adenomatous polyp,58 eosinophilic oesophagitis,49 oesophageal eosinophilia49 and atopy53. Our confidence level in the following was very low: H. pylori infection is associated with a decreased risk of oesophageal squamous cell carcinoma in Eastern populations,18 Barrett’s oesophagus,32 asthma,16 end-stage renal disease in adults,62 multiple sclerosis66 and gastro-oesophageal reflux disease30; decreasing high-density lipoprotein cholesterol54 and circulating ghrelin levels are also observed 46…”

“…Overall, 3036 articles that met our search criteria were first identified from the seven databases. Sixty articles9–18 27–76 of observational studies were finally selected, covering 88 unique outcomes (figure 1). Fifty-four meta-analyses10–17 28–34 38–40 42–44 47–50 54–60 64–70 72–75 were reanalysed because they did not present all of the results of estimates (i.e.…”

“…Among the 1239 individual studies, 274 (22%) were cross-sectional studies, 748 (60%) were case–control studies, 124 (10%) were cohort studies and 93 (8%) were mentioned as observational studies. Furthermore, 1 meta-analysis62 did not present the number of participants, and 12 meta-analyses27 35 36 41 45 49 51 53 54 61–63 72 did not present the number of cases. Among the meta-analyses that indicated the number of cases or participants, the median number of cases was 1032 (28–96 753) and the median number of participants was 3826 (222–377 976).…”

Helicobacter pylori infection and extragastric diseases in 2017

“…The estimated prevalence of H. pylori in end‐stage renal disease (ESRD) patients was 44% with a pooled RR of 0.77 (0.59‐1.00) when compared to non‐ESRD patients. In this meta‐analysis of 35 cross‐sectional studies, there was a decreased risk of H. pylori in adult ESRD patients (RR: 0.71; 0.55‐0.94) . The pooled risk RR of ESRD in patients with H. pylori was 0.61 (0.03‐12.20), but these data were limited to only two cohort studies with contradictory results and different selection criteria.…”

Helicobacter pylori and extragastric diseases

“…The results of a meta‐analysis published in early 2017 by Wijarnpreecha et al covering 35 cross‐sectional studies demonstrated a decreased risk of H. pylori in adults with end‐stage renal disease (ESRD), with a pooled RR of 0.77 (95% CI: 0.59, 1.00) when compared to the non‐ESRD group . Another meta‐analysis by the same authors included nine cross‐sectional studies and estimated a pooled OR of 1.20 (95% CI: 0.73, 1.97) for H. pylori positivity in patients with non‐dialysis‐dependent kidney disease when compared to controls.…”