Gastrointestinal evaluation in pediatric kidney transplantation candidates.
BACKGROUND
Our aim was to determine the frequency of peptic ulcer and Helicobacter pylori infection by gastrointestinal evaluations in pretransplantation phase in children with end-stage renal disease (ESRD).


METHODS
Twenty-four children with ESRD (13 girls and 11 boys) with a mean age of 14.7 +/- 3.4 years on maintenance hemodialysis were included in this study. Upper gastrointestinal endoscopies were performed and 4 gastric, antral, and duodenal biopsy specimens were obtained for urease test and histological study. Serum gastrin levels were measured in all patients, too. A control group was chosen to compare the rate of H pylori infection between children with ESRD and healthy children.


RESULTS
Gastrointestinal symptoms were present in 16 (66.7%) of 24 patients. Seventeen (70.8%) patients had abnormal upper gastrointestinal endoscopic findings. Infection with Helicobacter pylori was detected in 16 patients and 5 healthy children (66.7% versus 20.0%, P < .001). The frequency of dyspeptic symptoms was not different significantly between uremic patients with and without H pylori infection (P = .67). The same results were found regarding the upper gastrointestinal abnormalities found by endoscopy (P = .65). Oral alkalizing supplement was received by 63% of symptomatic and 80% of asymptomatic patients. Serum gastrin levels were significantly higher in infected patients than in noninfected patients with H pylori (P < .001).


CONCLUSIONS
We found a significant number of patients with peptic ulcer diseases, H pylori infection, and secondary hypergastrinemia. This study showed that clinical symptoms are not a reliable predictor of gastrointestinal problems and this is more confusing in patients who received alkalizing solutions.
Department of Pediatrics, Islamic Azad University, Mashhad, Iran. khazaeem@yahoo.com
Mahmood Reza
MR
Khazaei
Mohammad Hadi
MH
Imanieh
Ghamar
G
Hosseini Al-Hashemi
D000293:Adolescent; D001706:Biopsy; D016022:Case-Control Studies; D002648:Child; D004415:Dyspepsia / Q000150:complications; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005755:Gastrins / Q000097:blood; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy; D008297:Male; D010437:Peptic Ulcer / Q000150:complications* / Q000382:microbiology; D006435:Renal Dialysis; D055815:Young Adult
D005755:Gastrins