Helicobacter Pylori Serology in a Sample of Iraqi Patients with Chronic Renal Failure

Abstract

Background: The prevalence of gastrointestinal (GI) symptoms is high in patients with chronic renal failure. Peptic ulcer disease occurs in up to one-fourth of them. Many factors are implicated in its causation including Helicobacter pylori infection. Objective: The objective of the study was to determine the prevalence of H. pylori seropositivity in patients with GI symptoms and chronic renal failure compared with the prevalence of H. pylori seropositivity in patients with GI tract symptoms with normal renal function and to evaluate the importance of different factors that affect its prevalence depending on serological test for immunoglobulin level against H. pylori. Materials and Methods: This case–control study was done at the Department of Medicine, at Al Yarmook Teaching Hospital, Baghdad, Iraq. During the study period from January to June in 2004, ninety patients with chronic renal failure were interrogated for dyspeptic symptoms and 2 mL of blood was withdrawn for ELISA test for anti-H. pylori serological examination. Twenty-five dyspeptic patients with normal renal function were examined as well as control group. Results: from 90 patients with chronic renal failure, 42 patients were on hemodialysis and 48 patients were on peritoneal dialysis. There were 52 males and 38 females with age ranging 45.3 in male and female 43.1, respectively. The percentage of positive anti-H. pylori antibody was 60%. Only 44% of the control group had positive anti-H. pylori results. There was no statistically significant difference between anti-H. pylori positive and negative status in patients on hemodialysis, peritoneal dialysis, and control group regarding male and female gender. Again, there was no statistically significant difference in serpositivity in relation to epigastric pain and those without epigastric pain in the group of hemodialysis, peritoneal dialysis, and control group. Patients on peritoneal dialysis with dyspepsia of < 10 years had statistically significant seropositivity compared to those more than 10 years of epigastric pain. Those patients with hemodialysis and control group have no relation of seropositivity with dyspepsia duration. Conclusions: H. pylori serpositivity of patients with chronic renal failure was similar to that of the control. There is no relation between dyspepsia and H. pylori serpositivity. Long-term dialysis is associated with a decreased prevalence of H. pylori.