[Helicobacter pylori does not contribute to iron deficiency in hemodialysis patients].
BACKGROUND
Many studies in the general population have shown a link between Helicobacter pylori infection and iron-deficiency, often resulting in iron-deficient anaemia. Despite the high prevalence of iron deficiency in hemodialysis patients, no studies have been performed in this population.


OBJECTIVE
To evaluate the role of Helicobacter pylori infection in the appearance of anemia and the iron requirements in our hemodialysis population.


METHODS
After excluding patients with severe pathology and short life expectancy and those with blood losses secondary to other causes, 79 patients were included.Iron requirements and anaemia were determined by iron serum, ferritin, and hematocrit values; and by transfusion, eritropoietin and iron requirements. The diagnosis of Helicobacter pylori status was established by the concordance of at least two of the three non invasive diagnostic methods performed (breath test, serology and fecal antigen of Helicobacter pylori).


RESULTS
Prevalence of Helicobacter pylori infection was 43%. No significant differences between patients infected or not by Helicobacter pylori were found in any of the variables analysed: hematocrit (33.5% versus 34.1%), serum iron (58.9 versus 63.7 pg/dl), ferritin(340.3 versus 264.2 ng/ml), transferrin saturation index (22.5% versus 25.2%), dose of eritropoietin administered (96.6 versus 93.5 U/kg/weekly), and parenteral iron (1,389 versus 1,538 mg/year). A noteworthy finding was that patients with Helicobacter pylori infection had been on hemodialysis for a shorter period than those without (37.4 versus 63.7 months,p = 0.04).


CONCLUSIONS
Helicobacter pylori infection has no effect on anaemia (hematocrit, Eritropoietin dose or iron needs) in our hemodialysis patients. Prevalence of Helicobacter pylori is lower in patients with longer time on dialysis. We consider that the diagnosis of Helicobacter pylori infection must be reserved for clinical peptic ulcer suspicion or patients on transplant waiting list.
López
T
T
Servicio de Nefrología, Hospital de Sabadell, Institut Universitari Parc Tauli/UAB, Parc Tauli s/n, 08208 Sabadell, Barcelona. tlopeza@cspt.es
Almirall
J
J
Calvet
X
X
Quesada
M
M
Sanfeliú
I
I
Segura
F
F
García
M
M
D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology*; D015897:Comorbidity; D004415:Dyspepsia / Q000209:etiology; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006400:Hematocrit; D006801:Humans; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D014168:Transferrin / Q000032:analysis
D014168:Transferrin; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron