Role of Helocobacter pylori in Gastro-duodenl Mucosal Lesions in Patients with End-stage Renal Disease

Cho, Goon Jae; Lee, Soo Bong; Lee, Young Il; Park, Sung Min; Seong, Eun Young; Kwak, Ihm Soo; Rha, Ha Yeon

Abstract

Helocobacter pylori(Hp) is thought to play an important role in the pathogenesis of active gastritis and other upper gastrointestinal mucosal lesions. Although upper gastrointestinal mucosal lesion have been one of the most common complication in patients with chronic renal failure. A few reports are available regarding the prevalence of H. pylori and its influence on the upper gastrointestinal tract. The objective of our study was to evaluate the prevalence of Hp in end-stage renal failure who were undergoing dialysis. The study population consisted of seventeen patients with upper gastrointestinal tract symptoms. Thirty-six patients without any known kidney disease were used control. Gastric mucosa and gastric juice were obtained endoscopically. Rapid urease test(CLO test) were used for the determination of Hp. Hp was observed in 35.3% of the dialysis group and 77.8% of the control. Gastroduodenal lesion in Hp positive dialysis patients included erosive gastritis, atrophic gastritis and superficial gastritis. In the dialysis group, ammonia concentration in gastric juice were higher in patients with Hp than in those without Hp (461.5+/-211.1 vs. 244.4+/-168.1microgram/mL, p< 0.05). Patients with end-stage renal failure who were undergoing dialysis were shown to have a low prevalence of Hp colonization. In the end-stage renal failure, Hp is associated with peptic ulcer and chronic active gastritis but its influence on the upper gastro- intestinal tract is milder than in those of normal renal function. Several factor including Hp may play a role in the pathogenesis of gastointestinal mucosal lesion.