The Association of Helicobacter pylori Eradication with the Occurrences of Chronic Kidney Diseases in Patients with Peptic Ulcer Diseases

Abstract

The association of Helicobacter pylori eradication with the occurrence of renal dysfunction in patients with peptic ulcer diseases is still unclear. This study aimed to clarify the relevance of H. pylori eradication to the occurrence of chronic kidney diseases in patients with peptic ulcer diseases. Data that were available from 2000–2011 were extracted from the National Health Insurance Research Database in Taiwan, and all patients with peptic ulcer diseases (n = 208 196) were screened for eligibility. We divided randomly selected patients into an H. pylori eradication cohort (cohort A, n = 3593) and matched them by age and sex to a without H. pylori eradication cohort (cohort B, n = 3593). Subgroup analysis was further performed for H. pylori eradication within ≤ 90 days of the diagnosis date (early eradication, n = 2837) and within 91–365 days (non-early eradication, n = 756). Cox proportional hazards regression analysis was used to estimate the association of H. pylori eradication with the risk of developing chronic kidney diseases and mortality. We observed that there were more patients suffering from chronic kidney disease in cohort B than in the early eradication subgroup of cohort A (8.49% vs. 6.70%, respectively, p = 0.0075); the mortality rate was also higher in cohort B (4.76% vs. 3.70%, respectively, p = 0.0376). Old age, pulmonary disease, connective tissue disorders, and diabetes were risk factors for chronic kidney diseases but early H. pylori eradication was a protective factor against chronic kidney diseases (hazard ratio: 0.68, 95% confidence interval: 0.52–0.88, p = 0.0030), and death (hazard ratio: 0.69, 95% confidence interval: 0.49–0.96, p = 0.0297). In conclusion, our findings have important implications suggesting that early H. pylori eradication is mandatory since it is associated with a protective role against the occurrence of chronic kidney diseases.

First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

“…The physician should not be afraid of the adverse effect of these anti- H. pylori drugs. Instead, they should be more motivated to eradicate H. pylori in patients with CKD considering the potential complications and mortality in these patients who suffer from PUB [ 13 , 14 ]. With respect to the dosage, Ehsani Ardakani et al reported that half-dose triple therapy with clarithromycin, amoxicillin, and omeprazole is as effective as full-dose triple therapy in patients with ESRD [ 37 ].…”

“…According to the Taiwan National Health Insurance Research Database, although there is a lower H. pylori infection rate in patients with CKD (58.5%) and ESRD (56.2%) and PUD than in those with PUD without CKD (70.2%) [ 13 ], early H . pylori eradication (≤90 days) is highly suggested because it is associated with a protective role against the exacerbation of kidney malfunction and overall mortality [ 14 ].…”

Helicobacter pylori Infection is Associated with Occurrence of Proteinuria in Type 2 Diabetes Patients

“…In 2016, it was reported that early HP eradication is beneficial to patients with HP infection to avoid the occurrence of chronic kidney diseases. [ 51 ] Since proteinuria in patients with MN is decreased after HP eradication,[ 52 ] we speculated that HP eradication may be useful for T2DM patients in an effort to reduce the risk of proteinuria.…”

Multiple bacterial infections increase the risk of hepatic encephalopathy in patients with cirrhosis

“…pylori infection and eradication triple or quadruple therapy was defined as proton-pump inhibitor (PPI) or histamine type 2 receptor antagonists (H2RA) plus clarithromycin or metronidazole plus amoxicillin or tetracycline, with or without bismuth for 7–14 days. [ 20 , 21 ]…”