Gastric Helicobacter and Upper Gastrointestinal Symptoms in Chronic Renal Failure

Ala-Kaila, K; Vaajalahti, P; Karvonen, Anna‐Liisa; Kokki, M

doi:10.3109/07853899109148082

Cited by 29 publications

(17 citation statements)

References 24 publications

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“…,22 Most dialysis patients suffer from upper gastrointestinal symptoms 8,23. Similar results were found in our study, and almost all patients with ESRD undergoing PD experienced gastrointestinal discomfort.…”

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confidence: 87%

Gastroduodenal Lesions in Peritoneal Dialysis Patients: The Role of Helicobacter Pylon Infection

Abdul-Rahman

Al-Hwiesh

2012

Nephrology Research & Reviews

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The aim of this study was to examine the prevalence of Helicobacter pylori infection and the associated gastroduodenal lesions in peritoneal dialysis patients. Ninety-eight patients with dyspeptic complaints were included in the study. They were divided into two groups; group 1 consisted of 48 patients with endstage renal disease (ESRD) on PD and group 2 (control) of 50 patients without renal disease. All patients were subjected to upper gastrointestinal endoscopies, and gastric biopsies were obtained for histological evidence of H.pylori infection. Anti-H.pylori IgG antibodies were tested in the PD patients using the ELISA test. The mean age of both groups was similar. Twenty-three (47.9%) of the 48 patients on PD and 25 (50.0 %) of the 50 nonrenal disease patients were positive for H.pylori infection. There was no significant difference in H.pylori prevalence between the two groups (P>0.05). No correlation was found between H.pylori infection and age, sex, primary disease, or type (CAPD or APD). However, prevalence was significantly higher (30.4% vs 17.4%, P<0.001) in patients who were on PD for less than 24 months. False positive serology for H.pylori in the absence of positive histology was found in 7 out of the 25 negative cases (28.0 %) in the dialysis group. The prevalence of duodenal ulcers was significantly higher in H.pylori positive than in H.pylori negative ESRD patients on PD (18.8% vs 8.3%, P<0.05). Gastroesophageal reflux disease (GERD) was seen in 21 (43.8%) patients in group 1 and in 8 (16%) cases in group 2 (P<0.01). GERD was, however, significantly lower in H.pylori positive patients in both groups (12.5% vs 31.3% in group 1 and 4% vs 12% in group 2, P<0.001 and P<0.01, respectively). In conclusion, long-term PD seems to decrease the prevalence of H.pylori infection. Testing H.pylori antibodies lacks specificity for diagnosing active H.pylori infection in PD patients. H.pylori infection in patients on PD is associated with increased risk of gastroduodenal lesions and decreased prevalence of GERD

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supporting

confidence: 87%

Gastroduodenal Lesions in Peritoneal Dialysis Patients: The Role of Helicobacter Pylon Infection

Abdul-Rahman

Al-Hwiesh

2012

Nephrology Research & Reviews

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“…Offerhause et al [16] reported that H. pylori plays no role in ulcer dia thesis, while Ala-Kaila et al [17] reported significantly more frequent upper gastrointestinal symptoms and an tral gastritis in H. pylori-positive patients.…”

Section: Resultsmentioning

confidence: 99%

“…pylori due to the high gas tric urea and the immunosuppressive state. Several recent reports demonstrated a lower detection rate of H. pylori in uremics than normal controls [16][17][18], This may be a true finding which could be explained by frequent use of drugs including antibiotics by uremic patients or this could be due to false-negative testing, e.g. detection of antibody or urease test.…”

Section: Resultsmentioning

confidence: 99%

<i>Helicobacter pylori</i>and Uremic Gastritis: A Histopathologic Study and a Correlation with Endoscopic and Bacteriologic Findings

Moustafa

Khalil²,

Wahab³

et al. 1997

Am J Nephrol

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In this work 70 asymptomatic uremic patients under maintenance hemodialysis in our institution underwent upper-gastrointestinal endoscopy as part of a routine investigation prior to kidney transplantation. Their endoscopic findings were scored and antral mucosal biopsies were obtained and subjected to histopathologic and bacteriologic assessment. Bacteriologic examination included culture, rapid urease test, and microscopic examination for detection of Helicobacter pylori. Histopathologic examination of the gastric mucosa showed chronic superficial gastritis in 52%, atrophic gastritis in 5.7% and intestinal metaplasia in 37% of the cases. Of the cases with superficial gastritis, 5 showed in addition gastric mucosal dysplastic changes. There was no correlation between the histopathologic and endoscopic findings. Nevertheless, there was a significant association between histopathologic changes and H. pylori infection (p = 0.0001). All cases with atrophic gastritis showed H. pylori, and of 24 cases with chronic active superficial gastritis. H. pylori was detected in 18, while it was detected in only 2 of 13 cases with chronic inactive superficial gastritis and in 4 of 29 cases with normal antral mucosal biopsies. Among different variables in dialysis patients, only patients’ ages were found to have significant association with H. pylori infection (p < 0.03). We have concluded that in asymptomatic uremic patients under maintenance hemodialysis, relying only on endoscopy for critical assessment of the upper gastrointestinal tract is unsatisfactory and histopathologic examination of the antral mucosal biopsies is mandatory. Chronic superficial gastritis and atrophic gastritis should be expected in up to 60% of the patients, and there is a strong association between H. pylori infection and gastritis.

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“…Ala-Kaila et al showed that pentagastrin-stimulated gastric acid secretion is greater in //. pylori-positive patients with chronic renal failure than in their H. pylori-ncg^tive counterparts (6). In addition to augmentation of the gastric acid secretion, H. pylori may cause mucosal injury due to the increased production ofgastricjuice ammonia (24,25).…”

Section: Discussionmentioning

confidence: 99%

“…However, studies on the influence of H. pylori infection on the serum gastrin concentration in patients with end-stage renal disease have been limited and the results are conflicting. Luzza et al reported thatpatients on dialysis with H. pylori infection exhibit a higher serum gastrin concentration than those without H. pylori infection (5), while other studies have not found such differences (6)(7)(8).…”

Section: Introductionmentioning

confidence: 98%

Eradication of Helicobacter pylori Restores Elevation of Serum Gastrin Concentrations in Patients with End-Stage Renal Disease.

et al. 1998

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In order to explore the role ofHelicobacterpylori (H. pylori) infection in hypergastrinemia in patients on dialysis, the changes in serum gastrin concentration were examinedbefore and after eradication treatment for H. pylori. Twenty-seven patients on dialysis were treated for the eradication of H. pylori Fasting serum gastrin concentrations were measured by a radioimmunoassay which detects gastrin 17. Ammoniaand pHlevels of the gastricjuice were also measured. The serum gastrin concentrations were significantly decreased following eradication of if. pylori, and the meanvalue reached the normalrange. The restoration ofhypergastrinemiawas associated with marked reductions of gastric juice ammonia and pH levels. In contrast, patients in whomH. pylori was not eradicated showed no changes in these parameters. In conclusion, the elevation of the fasting serum gastrin 17 concentration seen in dialysis patients appeared to be attributable to H. pylori infection in the stomach.

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Gastric Helicobacter and Upper Gastrointestinal Symptoms in Chronic Renal Failure

Cited by 29 publications

References 24 publications

Gastroduodenal Lesions in Peritoneal Dialysis Patients: The Role of Helicobacter Pylon Infection

Gastroduodenal Lesions in Peritoneal Dialysis Patients: The Role of Helicobacter Pylon Infection

<i>Helicobacter pylori</i>and Uremic Gastritis: A Histopathologic Study and a Correlation with Endoscopic and Bacteriologic Findings

Eradication of Helicobacter pylori Restores Elevation of Serum Gastrin Concentrations in Patients with End-Stage Renal Disease.

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