title: Association between early Helicobacter pylori eradication and a lower risk of recurrent complicated peptic ulcers in end-stage renal disease patients.
abstract: End-stage renal disease (ESRD) patients exhibit an increased incidence of peptic ulcer disease. Helicobacter pylori plays a central role in the development of peptic ulcers. The effect of early H pylori eradication on the recurrence of complicated peptic ulcer disease in ESRD patients remains unclear. The aim of the present study was to explore whether early H pylori eradication therapy in ESRD patients can reduce the risk of recurrent complicated peptic ulcers.We conducted a population-based cohort study and recruited patients with ESRD who had developed peptic ulcers. We categorized patients into early (time lag ≦120 days after peptic ulcer diagnosis) and late H pylori eradication therapy groups. The Cox proportional hazards model was used. The endpoint was based on hospitalization for complicated recurrent peptic ulcers.The early and late H pylori eradication therapy groups consisted of 2406 and 1356 ESRD patients, respectively, in a time lag of 120 days. After adjusting for possible confounders, the early eradication group exhibited a lower rate of complicated recurrent peptic ulcer disease (hazard ratio [HR] = 0.76, 95% confidence interval [CI] = 0.64-0.91, P = 0.003) in a time lag of ≦120 days, but a similar rate of complicated recurrent peptic ulcer disease in time lags of ≦1 year (HR = 0.97, 95% CI 0.79-1.19, P = 0.758) and 2 years (HR = 1.11, 95% CI 0.86-1.44, P = 0.433) compared with the late eradication group.We recommend administering H pylori eradication within 120 days after peptic ulcer diagnosis to H pylori infected ESRD patients who have developed peptic ulcers.
authors.affiliation: From the Division of Gastroenterology (S-SC), Department of Internal Medicine, Taipei City Hospital Yang-Ming Branch; School of Medicine (S-SC); Institute of Public Health & Department of Public Health (H-YH), National Yang-Ming University; and Department of Education and Research (H-YH), Taipei City Hospital, Taipei, Taiwan.
authors.forename: Shen-Shong
authors.initials: SS
authors.lastname: Chang
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000150:complications / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012008:Recurrence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors