[Helicobacter pylori seroprevalence in dialysis patients].
OBJECTIVE
(a) to establish Hp infection seroprevalence among patients under chronic dialysis and to compare it with that of general population, (b) to assess the relationship between Hp prevalence and parameters associated with a higher morbidity, such as serum albumin levels, dialysis adequacy, and quality of life in this population.


METHODS
Ninety-three consecutive patients of both genders (58 M/35 F), X 57.5 +/- 17.2 years old, with end-stage chronic renal failure on maintenance dialysis were included. All of them received dialysis at Hospital Italiano, Buenos Aires. The presence of anti-Hp antibodies was established and its prevalence was compared with a control group. In all cases, serum albumin levels and time in dialysis were determined. In addition, dialysis adequacy was established by KT/V and quality of life was measured with Karnofsky's index. Patients and controls were matched according variables associated with Hp infection in our country, i.e., age, socioeconomic and education levels.


RESULTS
Ninety-three dialysis patients were matched with 93 controls. According to the quick serological test, 44 out of 93 (47.3%) dialyzed patients and 55 out of 93 (53.6%) controls were Hp positive (ns). Forty-one out of 76 patients (53.9%) with a serum albumin level 3.5 g/dl and 3/17 (17.6%) with a serum albumin level < 3.5 g/dl were anti-Hp positive (odds ratio, 0.06; 95% CI, 0.01-0.39; p < 0.01). Fifty-five out of 80 patients (69.2%) with Kt/V > 1.2 and 6/13 (43.8%) with Kt/V 1.2 Pounds were anti-Hp positive (odds ratio, 0.10; 95% CI, 0.02-0.65; p < 0.05). Four out of 15 patients (26.7%) with Karnofsky's index > 70, and 40/78 (51.3%) with Karnofsky's index < or = 70 were anti-Hp positive (odds ratio, 0.37; 95% CI, 0.06-2.95, p = 0.26).


CONCLUSIONS
According to our results, dialysis patients do no represent a high-risk group of Hp infection. Those individuals with higher morbidity and mortality rates as evidenced by low serum albumin levels or by a low Kt/V have a lower Hp prevalence, perhaps due to a poor immune response o due to the use of antibiotics. Therefore, Hp infection screening en dialysis units does not differ from the guidelines developed in Maastrich for the general population.
Olmos
J A
JA
Servicios de Gastroenterología y Nefrología, Hospital Italiano, Buenos Aires, Argentina. jolmos@intramed.net.ar
Rosa Diez
G
G
Higa
R
R
Algranati
S
S
Ríos
H
H
De Paula
J A
JA
Dos Ramos Farías
E
E
Dávolos
J
J
D001118:Argentina / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016480:Helicobacter pylori; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000032:analysis; D012959:Socioeconomic Factors; D013997:Time Factors
D012709:Serum Albumin