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Helicobacter pylori infection in hemodialysis patients
Authors:Tsukada Katsuhiko  Miyazaki Tatsuya  Katoh Hiroyuki  Yoshikawa Minako  Masuda Norihiro  Ojima Hitoshi  Tajima Kohei  Fukai Yasuyuki  Nakajima Masanobu  Kamiyama Youichi  Kuwano Hiroyuki  Tsukada Osamu
Institution:Department of First Surgery, Gunma University School of Medicine 3-39-22 Showamachi Maebashi, 371-8511 Japan. katukada@topaz.ocn.ne.jp
Abstract:BACKGROUND/AIMS: Studies on the relationship between high serum urea nitrogen, creatinine and Helicobacter pylori infection in hemodialysis patients still give conflicting results. In the present study we investigated the prevalence of Helicobacter pylori positivity in patients with hemodialysis HD(+)] and without hemodialysis HD(-)] and assessed the relationship between clinical factors, serum urea nitrogen, creatinine levels and Helicobacter pylori prevalence in these patients. METHODOLOGY: 117 patients with dyspeptic complaints were included in the study. They consisted of 36 HD(+) patients (31%) and 81 HD(-) patients (69%). Endoscopy was performed and gastric antral biopsies were obtained for immunohistochemical analysis for Helicobacter pylori in all patients. RESULTS: Helicobacter pylori was positive in 53(45%) of 117 patients Hp(+)]. In univariate analysis Hp(+) patients received hemodialysis therapy significantly less often (P = 0.002) and had lower serum urea nitrogen (P = 0.0008) and creatinine (P = 0.003) levels than Hp(-) patients. There was no significant difference in age, gender, endoscopic findings or comorbid conditions (hypertension or diabetes mellitus) between these groups. Multivariate logistic regression analysis revealed that only the serum urea nitrogen level was significantly associated with Helicobacter pylori prevalence (P = 0.008). CONCLUSIONS: These results indicate that high serum urea nitrogen seems to correlate with a low prevalence of Helicobacter pylori infection and hemodialysis patients with high serum urea nitrogen may be protected against Helicobacter pylori infection.
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