Helicobacter pylori status and esophagogastroduodenal mucosal lesions in patients with end-stage renal failure on maintenance hemodialysis.
OBJECTIVE
The aim of this study was to elucidate the impact of Helicobacter pylori infection on esophagogastroduodenal mucosal lesions in patients with end-stage renal failure on maintenance hemodialysis (HD).


METHODS
An upper endoscopy and the (13)C-urea breath test were performed in 198 patients on maintenance HD. Clinical features, serum pepsinogen levels and esophagogastroduodenal mucosal lesions were compared between H. pylori-positive and H. pylori-negative patients. Risk factors associated with esophagogastroduodenal mucosal lesion were determined by multivariate analyses.


RESULTS
The upper endoscopy revealed that gastric erosion was the most frequent (58%) type of esophagogastroduodenal mucosal lesion, followed by duodenal erosion (18%), gastric ulcer (14%), gastroesophageal reflux disease (10%), and duodenal ulcer (7%). Of the 198 patients enrolled in the study, 81 were positive and 117 patients were negative for H. pylori infection. The time duration after the introduction of HD was significantly longer and serum pepsinogen I/II ratio was significantly higher in H. pylori-negative patients than in H. pylori-positive patients. Multivariate analyses revealed that the H. pylori infection was an independent, protective factor for gastric erosion (odds ratio 0.38; 95% confidence interval 0.21-0.70), while the infection was unrelated to other mucosal lesions.


CONCLUSIONS
The most common mucosal lesion observed in our study cohort, all of whom were patients on maintenance HD, was gastric erosion. The high prevalence of this type of lesion may be explained partly by the cure of H. pylori infection during the clinical course of maintenance HD.
Moriyama
Tomohiko
T
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. morimori@intmed2.med.kyushu-u.ac.jp
Matsumoto
Takayuki
T
Hirakawa
Katsuya
K
Ikeda
Hirofumi
H
Tsuruya
Kazuhiko
K
Hirakata
Hideki
H
Iida
Mitsuo
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D016145:Endoscopy, Digestive System; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D007676:Kidney Failure, Chronic / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*; D015995:Prevalence; D006435:Renal Dialysis; D055815:Young Adult