Helicobacter pylori status and esophagogastroduodenal mucosal lesions in patients with end-stage renal failure on maintenance hemodialysis

Abstract

The most common mucosal lesion observed in our study cohort, all of whom were patients on maintenance HD, was gastric erosion. The high prevalence of this type of lesion may be explained partly by the cure of H. pylori infection during the clinical course of maintenance HD.

Natural Course of <b><i>Helicobacter pylori</i></b> Infection in Japanese Hemodialysis Patients

“…Moriyama et al [18] reported that hemodialysis patients with H. pylori infection had a higher serum PG II level and a lower PG I/II ratio than H. pylori -negatives and that the PG II level and PG I/II ratio were predictive of gastric mucosal atrophy even in hemodialysis patients. In this study, we showed the ROC curve using PG I level and PG I/II ratio for discriminating the H. pylori -negatives from the other patients in the entire cohort, and also that PG I/II ratio showed the best diagnostic accuracy for discriminating H. pylori -negatives.…”

“…The prevalence of H. pylori infection in patients receiving CAPD and hemodialysis has been shown to be less than or equal to that in healthy subjects in various different geographic populations [17,18,19,20]. Our previous cohort study in 1997 in 539 Japanese hemodialysis patients with a mean treatment duration of 8.4 ± 0.3 years showed a prevalence of H. pylori infection of 48.6% (95% CI 44.3-52.9), which was significantly lower than that in dyspepsia patients with normal renal function (78.5%, 95% CI 74.1-82.4, p < 0.001) or healthy individuals undergoing screening (69.4%, 95% CI 60.3-77.5, p < 0.001) [17].…”

“…A recent large-scale Japanese epidemiological study showed that the infection rate has declined to 30-50%, especially in younger patients [16]. The prevalence of H. pylori infection in patients receiving dialysis has been investigated, and in most studies, the infection rate in patients with chronic kidney disease receiving continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis is shown to be equal to or lower than that in subjects with normal renal function in various population groups [17,18,19,20]. Thus, at a time when infection rates of H. pylori are decreasing, the infection rate in hemodialysis patients is also expected to decrease.…”

Helicobacterpylori Infection for Hemodialysis Patients

“…Nakajima et al report that the prevalence of HP infection gradually decreases with a 2-year or longer duration of hemodialysis, and Sugimoto et al reported that the prevalence gradually decreases within 4 years of hemodialysis [15]. Moriyama et al report that such a tendency is revealed in patients receiving hemodialysis for 8 years or longer [20]. There is also a report that the prevalence of HP infection in health check-up examinees with normal renal function was similar to that in patients with chronic renal failure who had received hemodialysis for less than 1 year [15].…”

“…How are duration of hemodialysis and prevalence of HP infection associated? There are reports that the prevalence of HP infection tends to be lower with longer duration of hemodialysis [9,15,20,21]. Nakajima et al report that the prevalence of HP infection gradually decreases with a 2-year or longer duration of hemodialysis, and Sugimoto et al reported that the prevalence gradually decreases within 4 years of hemodialysis [15].…”