Gastroduodenal lesions and Helicobacter pylori infection in dyspeptic patients with and without chronic renal failure.
BACKGROUND
Patients with chronic renal failure (CRF) often have dyspeptic symptoms and may develop peptic disease or digestive disorders leading to severe gastrointestinal complications. The primary aim of this study was to evaluate the prevalence of peptic lesions and Helicobacter pylori infection, and the severity of dyspeptic symptoms, in dyspeptic patients with and without CRF. Our secondary aim was to investigate whether uremic status may affect the diagnostic efficiency of the [13]C-urea breath test ([13]C-UBT).


METHODS
We consecutively enrolled in the study 50 dyspeptic patients with chronic kidney failure (mean age 52 +/- 5 years), of whom 11 were on hemodialysis treatment (HD), and 93 subjects (mean age 54 +/- 7 years) with chronic dyspepsia and normal renal function (NRF). All patients completed an oriented and validated questionnaire scoring the severity of nine dyspeptic symptoms (i.e. epigastric pain, epigastric burning, postprandial fullness, early satiety, bloating, belching, nausea and vomiting) and underwent upper endoscopy with multiple bioptic sampling for rapid urease test and histological examination, [13]C-UBT and HpSA test.


RESULTS
The prevalences of peptic lesions and H. pylori infection and mean symptom score were 74%, 52% and 3.5 +/- 3, respectively, in dyspeptic patients with CRF and 18%, 36% and 8 +/- 5, respectively, in dyspeptic patients with NRF. The diagnostic accuracy of [13]C-UBT with respect to histological diagnosis was 94% and 97% for dyspeptic patients with and without renal failure, respectively.


CONCLUSIONS
1, A high frequency of peptic lesions and low symptom scores were observed in uremic patients in spite of H. pylori infection; 2, uremic status did not affect the diagnostic accuracy of [13]C-UBT.
Nardone
Gerardo
G
Department of Clinical and Experimental Medicine, Gastroenterology Unit, University Federico II, Via Pansini n degree 580131 Naples, Italy. nardone@unina.it
Rocco
Alba
A
Fiorillo
Maria
M
Del Pezzo
Mariassunta
M
Autiero
Giovanni
G
Cuomo
Rosario
R
Sarnelli
Giovanni
G
Lambiase
Antonietta
A
Budillon
Gabriele
G
Cianciaruso
Bruno
B
D000328:Adult; D000942:Antigens, Bacterial / Q000032:analysis; D001706:Biopsy; D001944:Breath Tests; D004415:Dyspepsia / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000201:enzymology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications*; D011237:Predictive Value of Tests; D014508:Urea / Q000032:analysis
D000942:Antigens, Bacterial; D014508:Urea