Korean Journal of Gastrointestinal Endoscopy 2000;20(2): 97-102.
말기 신부전 환자에서 Helicobacter pylori 유병률 ( Prevalence of Helicobacter pylori in Patients with End Stage Renal Disease )
김도하(Do Ha Kim),정훈용(Hwoon Yong Jung),양석균(Suk Kyun Yang),홍원선(Weon Seon Hong),민영일(Young Il Min)
Abstract
Background/Aims : It has been reported that patients with chronic renal failure have a tendency foward increased incidences of peptic ulcer diseases. However, it is yet unclear whether the increased incidence is due to altered gastric acidity, hypersecretin of gastrin, or increased colonization of Helicobacter pylori (H. pylori). This study was conducted to investigate the role of H. pylori in the development of peptic ulcer diseases in patients with chronic renal failure. Method : Forty nine patients with end stage renal disease (ESRD) and 41 age-matched controls with normal renal function, were examined for H. pylori infection using a rapid urease test, histological examination with Hematoxylin, Eosin, Warthin-Starry silver stain, and culture. The presence of H. pylori was defined either as the positive culture or as positive for both CLO and histological examination. Results : Ninteen (38.8%) out of 49 ESRD patients were positive for H. pylori, which was lower than 70.7% of the controls (p＜0.01). Endoscopic examination revealed that 6 ESRD patients (12.2%) had peptic ulcers, while 2.4% of the controls did, which was not statistically significant. The ESRD patients were divided into two groups by therapeutic modality: group 1 included 31 patients under dialysis, and group 2, 18 patients with maintenance therapy. The incidence of H. pylori infection in group 1 was 51.6%, which was significantly higher than the 16.7% in group 2 (p＜0.05). Conclusions : The results of this study suggest that the increased incidence of peptic ulcers in ESRD patients cannot be explained by H. pylori colonization, and that there may be other factors such as a high concentration of urea in the stomach of patients with ESRD, which can suppress the colonization of H. pylori. (Korean J Gastrointest Endosc 2000;20:97 102)
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