Gut Liver.  2019 Nov;13(6):628-641. 10.5009/gnl18517.

Helicobacter pylori Infection in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

• Shin SP
• Bang CS
• Lee JJ
• Baik GH

• KMID: 2464310
• DOI: http://doi.org/10.5009/gnl18517

Abstract

BACKGROUND/AIMS
Insufficient systematic reviews were conducted in the previous meta-analyses about the prevalence of Helicobacter pylori infection in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prevalence of H. pylori infection in patients with CKD.
METHODS
A systematic review of studies that evaluated the prevalence of H. pylori infection in patients with CKD compared to a control group was performed. Only studies with adult patients were included, and studies with renal transplant recipients or diabetic nephropathy patients were excluded. Random-effects model meta-analyses with sensitivity analyses and subgroup analyses were conducted to confirm the robustness of the main result. A meta-regression analysis was conducted to explore the influence of potential heterogeneity on the outcomes. The methodological quality of the included publications was evaluated using the Risk of Bias Assessment tool for Nonrandomized Studies. Publication bias was also assessed.
RESULTS
In total, 47 studies were identified and analyzed. The total prevalence of H. pylori infection was 48.2% (1,968/4,084) in patients with CKD and 59.3% (4,097/6,908) in the control group. Pooled analysis showed a significantly lower prevalence of H. pylori infection in patients with CKD (vs control group: odds ratio, 0.64; 95% confidence interval, 0.52 to 0.79). Sensitivity analyses revealed consistent results, and meta-regression analysis showed no significant confounders. No publication bias was detected.
CONCLUSIONS
The results of this study suggest a lower prevalence of H. pylori infection in patients with CKD.

Keyword

Helicobacter pylori; Meta-analysis; Chronic kidney disease

MeSH Terms

Adult
Bias (Epidemiology)
Diabetic Nephropathies
Helicobacter pylori*
Helicobacter*
Humans
Odds Ratio
Population Characteristics
Prevalence
Publication Bias
Renal Insufficiency, Chronic*
Transplant Recipients