Role of Helicobacter pylori in gastro-duodenal mucosal lesions in patients with end-stage renal disease under dialysis treatment

It is known that Helicobacter pylori (H.pylori) plays an important role in gastritis and peptic ulcer disease in the general population. Although upper gastrointestinal mucosal lesions have been one of the most common complications in patients with chronic renal failure, quite few reports are available regarding the prevalance of H. pylori and its influence on the upper gastro-intestinal tract. The present study was conducted to examine whether H, pylori is involved in the pathogenesis of upper gastroin testinal mucosal lesions in dialysis patients. The subjects consisted of 43 dialysis patients with upper gastro-intestinal tract symptoms. Thirty-four patients without any known kidney disease were used as controls. Gastric mucosa and gastric juice were obtained endoscopically. For the determination of H. pylori, culture of biopsy specimens from the gastric mucosa and histopathological examination with hematoxylin-eosin stain were used. Concentrations of serum gastrin and gastric juice ammonia were also measured. H. pylori was observed in 53.5% of the dialysis group and 64.0% of the controls. Gastro-duodenal lesions in H. pylori-positive dialysis patients included atrophic gastritis, superficial gastritis, erosive gastritis, and gastric ulcer. In the dialysis group, ammonia concentrations in the gastric juice were higher in patients with H. pylori than in those without H. pylori (489.1±35.8μg /ml vs 67.0±19.2μg/ml, p