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Prevalence of Helicobacter pylori in patients with chronic renal failure
1Department of Internal Medicine II, Technical University of Aachen, Germany.
Insights
Higher urea levels in patients with renal failure do not increase the risk of Helicobacter pylori infection. This study found no significant difference in H. pylori prevalence across varying degrees of kidney function.
Area of Science:
- Gastroenterology
- Nephrology
- Microbiology
Background:
- Helicobacter pylori (H. pylori) is a common bacterium infecting the gastric mucosa.
- Renal dysfunction can lead to elevated urea levels, potentially affecting gastric conditions.
- Urea-splitting bacteria like H. pylori may be influenced by urea concentrations in gastric juice.
Purpose of the Study:
- To investigate the prevalence of H. pylori in patients with varying renal function.
- To determine if elevated urea concentrations in gastric juice influence H. pylori colonization.
- To assess the relationship between renal function, urea levels, and H. pylori infection.
Main Methods:
- A study of 164 patients categorized into normal renal function, chronic renal failure, and hemodialysis groups.
- Combined results from urease test, Warthin-Starry stain, bacterial cultivation, and phase-contrast microscopy for H. pylori detection.
- Analysis of gastric juice pH, serum gastrin, and ammonia concentration in relation to H. pylori prevalence.
Main Results:
- No statistically significant differences in H. pylori prevalence were found between the groups (34-54%).
- Elevated serum gastrin levels in patients with renal dysfunction did not impact gastric juice pH.
- A linear relationship was observed between H. pylori colonization index and gastric juice ammonia concentration.
Conclusions:
- Higher blood and gastric urea levels in patients with renal failure are not a risk factor for H. pylori infection.
- Renal function status does not appear to significantly alter H. pylori colonization of the gastric mucosa.
- Ammonia concentration in gastric juice shows a correlation with H. pylori presence, irrespective of renal function.
Abstract:
The prevalence of Helicobacter pylori (H. pylori) was investigated in 164 consecutive patients with different degrees of renal function; group I (normal renal function) n = 84, group II (chronic renal failure, CLCR > or = 5 < 90 ml/min) n = 45, group III (haemodialysis therapy) n = 35, to test the hypothesis that the resulting different concentrations of urea in the gastric juice would have an influence on the colonization of the gastric mucosa by these urea-splitting bacteria. As every individual method for the detection of H. pylori shows disadvantages, the results of the detection methods used (urease test, Warthin-Starry stain, bacterial cultivation, direct examination of the processed sample by phase-contrast microscopy) were combined in a cumulative evaluation. These calculated cumulative indices for the antrum and corpus showed no statistically significant differences between the studied groups. The prevalence of H. pylori ranged from 34 to 54%. The histopathological findings were similar in all groups. In spite of the fact that patients with renal dysfunction had significantly higher levels of serum gastrin (P < 0.05), there was no influence on the gastric juice pH value. The relationship between the cumulative index and ammonia concentration in gastric juice was found to be linear (P < 0.05). The higher urea levels in the blood and gastric juice of patients with renal failure do not seem to be a risk factor for infection with H. pylori.