Evaluation of noninvasive tests for diagnosis of Helicobacter pylori infection in hemodialysis patients.
BACKGROUND
Hemodialysis is the most common method of renal replacement therapy for treatment of acute and chronic kidney failure. Helicobacter pylori (H. pylori) plays a major role in development of peptic ulcer, gastric neoplasms, and lymphoma as well as increased risk of cardiovascular disorders in hemodialysis patients.


OBJECTIVE
In this study the diagnostic values of noninvasive tests [i.e. urea breath test (UBT), helicobacter pylori stool antigen test (HPSA) and serology] in diagnosis of H. pylori infection in hemodialysis patients have been studied.


METHODS
All patients undergoing hemodialysis in Fatemieh Hospital, Semnan, Iran, were enrolled in the study, and their H. pylori status were assessed by using non-invasive tests including UBT, HPSA and serology. Patients with at least two out of 3 positive tests were considered infected with H. pylori.


RESULTS
The sensitivity, specificity, and positive and negative predictive values of the tests used in diagnosing H. pylori infection were 62.5%, 65.4%, 62.5% and 65.4% for UBT, 100%, 72.2%, 58.3% and 100% for serology, and 100%, 75%, 60.9% and 100% for fecal antigen test, respectively.


CONCLUSIONS
This study showed that H. pylori serology and stool antigen tests have higher diagnostic values than UBT, and they are more reliable than UBT in diagnosis of H. pylori infection in hemodialysis patients.
Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Mohamad Reza
MR
Tamadon
Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Morteza
M
Saberi Far
Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Alireza
A
Soleimani
Department of Social Medicine Semnan University of Medical Sciences, Semnan, Iran.
Raheb
R
Ghorbani
Department of Pathology, Semnan University of Medical Sciences, Semnan, Iran.
Vahid
V
Semnani
Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Farhad
F
Malek
Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (TUMS), Tehran, Iran.
Mojtaba
M
Malek
Helicobacter pylori; Hemodialysis; Urea breath test