Advantage of eradication therapy for Helicobacter pylori before kidney transplantation in uremic patients.
From January 1999 to February 2007, 61 end-stage renal disease (ESRD) candidates for kidney transplantation underwent an esophagogastroduodenoscopy (EGDS) to detect Helicobacter pylori (HP). We correlated treatment for HP before transplantation and upper digestive tract hemorrhagic complications and possible recurrence of peptic disease posttransplantation. The 32 (52.4%) HP-Positive cases were divided into 2 groups: (1) 17 patients who underwent treatment for the eradication of the infection with 40 mg/d omeprazole for 4 weeks, 500 mg claritromycin twice daily for 7 days, and 2 g/d amoxicillin for 7 days; and (2) 15 untreated patients. No significant differences were found in the hemorrhagic erosive gastritis of patients with regard to the treated HP-Positive and nontreated HP-Positive patients (2 vs 3) and between the HP-negative patients and the nontreated HP-Positive patients (2 vs 3). The presence of gastric or duodenal ulcers was significantly higher in the nontreated patient than in the treated HP-positive patients (5 vs 1; P=.05) and significantly higher in the nontreated HP-Positive patients than in the HP-negative patients (5 vs 0; P=.05). We concluded that HP-positive patients should therefore be treated for the infection to avoid a long-term significant increase of gastric and/or duodenal peptic disease subsequent to renal transplantation in these immunodepressed subjects.
Cocchiara
G
G
Department of General Surgery and Organ Transplantation, University of Palermo, School of Medicine, Palermo, Italy. gerlandococchiara@libero.it
Romano
M
M
Buscemi
G
G
Maione
C
C
Maniaci
S
S
Romano
G
G
D004381:Duodenal Ulcer / Q000453:epidemiology / Q000382:microbiology; D005756:Gastritis / Q000453:epidemiology / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology*; D011183:Postoperative Complications / Q000145:classification; D011300:Preoperative Care; D013276:Stomach Ulcer / Q000453:epidemiology / Q000382:microbiology; D014511:Uremia / Q000150:complications* / Q000382:microbiology / Q000601:surgery*