title: The Association of Helicobacter pylori Eradication with the Occurrences of Chronic Kidney Diseases in Patients with Peptic Ulcer Diseases.
abstract: The association of Helicobacter pylori eradication with the occurrence of renal dysfunction in patients with peptic ulcer diseases is still unclear. This study aimed to clarify the relevance of H. pylori eradication to the occurrence of chronic kidney diseases in patients with peptic ulcer diseases. Data that were available from 2000-2011 were extracted from the National Health Insurance Research Database in Taiwan, and all patients with peptic ulcer diseases (n = 208 196) were screened for eligibility. We divided randomly selected patients into an H. pylori eradication cohort (cohort A, n = 3593) and matched them by age and sex to a without H. pylori eradication cohort (cohort B, n = 3593). Subgroup analysis was further performed for H. pylori eradication within ≤ 90 days of the diagnosis date (early eradication, n = 2837) and within 91-365 days (non-early eradication, n = 756). Cox proportional hazards regression analysis was used to estimate the association of H. pylori eradication with the risk of developing chronic kidney diseases and mortality. We observed that there were more patients suffering from chronic kidney disease in cohort B than in the early eradication subgroup of cohort A (8.49% vs. 6.70%, respectively, p = 0.0075); the mortality rate was also higher in cohort B (4.76% vs. 3.70%, respectively, p = 0.0376). Old age, pulmonary disease, connective tissue disorders, and diabetes were risk factors for chronic kidney diseases but early H. pylori eradication was a protective factor against chronic kidney diseases (hazard ratio: 0.68, 95% confidence interval: 0.52-0.88, p = 0.0030), and death (hazard ratio: 0.69, 95% confidence interval: 0.49-0.96, p = 0.0297). In conclusion, our findings have important implications suggesting that early H. pylori eradication is mandatory since it is associated with a protective role against the occurrence of chronic kidney diseases.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Jiunn-Wei
authors.initials: JW
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chien-Ning
authors.initials: CN
authors.lastname: Hsu
authors.affiliation: Division of Hepato-gastroenterology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Tai
authors.affiliation: Division of Gastroenterology; FooYin University Hospital, Pin-Tung, Taiwan.
authors.forename: Ming-Kun
authors.initials: MK
authors.lastname: Ku
authors.affiliation: Division of Hepato-gastroenterology; Department of Internal Medicine, Buddist Tzu Chi General Hospital, Dalin Branch, Taiwan.
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Hung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Kuo-Lun
authors.initials: KL
authors.lastname: Tseng
authors.affiliation: Divisions of Gastroenterology, Yuan General Hospital, Kaohsiung, Taiwan.
authors.forename: Lan-Ting
authors.initials: LT
authors.lastname: Yuan
authors.affiliation: Division of Gastroenterology; Pin-Tung Christian Hospital, Pin-Tung, Taiwan.
authors.forename: Seng-Howe
authors.initials: SH
authors.lastname: Nguang
authors.affiliation: Division of Hepato-gastroenterology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Liang
authors.affiliation: Division of Hepato-gastroenterology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Shih-Cheng
authors.initials: SC
authors.lastname: Yang
authors.affiliation: Division of Hepato-gastroenterology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Kun
authors.initials: CK
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, National Yang-Ming University, Kaohsiung, Taiwan.
authors.forename: Pin-I
authors.initials: PI
authors.lastname: Hsu
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.affiliation: Division of Hepato-gastroenterology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
authors.forename: Seng-Kee
authors.initials: SK
authors.lastname: Chuah
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D003240:Connective Tissue Diseases / Q000150:complications; D016208:Databases, Factual; D048909:Diabetes Complications / Q000175:diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis*; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents