engleski

Are Dyspeptic Symptoms in Chronic Renal Failure Aggravated by Helicobacter pylori Infection?

Background. Patients with chronic renal failure (CRF) often suffer from dyspeptic symptoms and have an increased incidence of gastritis, peptic ulceration, and upper gastrointestinal hemorrhage. It has been suggested that the main underlying reasons for the dyspepsia are a high serum gastrin level, a high concentration of urea in the serum and gastrointestinal mucosa, and Helicobacter pylori (H. pylori) infection. This study was performed to determine the prevalence of H. pylori infection in CRF patients and to assess the relationship between H. pylori infection and the severity of dyspeptic symptoms in these patients. Methods. Interviews, clinical examinations, and gastroduodenoscopies were performed ; gastric biopsies were obtained for the rapid urease test, histology, and culture ; and serum H. pylori-specific IgG was measured. Results. One hundred sixty-nine patients were included in the study: 55 CRF patients on chronic hemodialysis (Dialysis Group), 51 CRF patients not on dialysis (10<ClCr<60 ml/min) (CRF Group), and 63 dyspeptic patients with normal renal function (Control Group). All groups were comparable in terms of age, sex, and smoking habits. Twenty-three patients (41.8%) in the Dialysis Group, 24 (47.1%) in the CRF Group, and 37 (58.7%) in the Control Group were H. pylori-positive (p = 0.056). The presence of H. pylori infection in the uremic patients strongly correlated with the severity of dyspeptic symptoms and with histological changes of the gastric mucosa, according to the Sydney score. There was no relation between H. pylori infection and the renal failure etiology or duration, or with the duration of dialysis. Antibiotic resistance of isolated H. pylori ranged from 12– 23%. Conclusions. The dyspeptic symptoms in uremic patients are aggravated by H. pylori infection. The prevalence of H. pylori infection in uremic patients is lower than in dyspeptic patients with normal renal function.

dialysis ; hemodialysis-patients ; uremic patients ; eradication ; resistance ; efficacy ; therapy ; tests

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