Helicobacter pylori prevalence and its association with endoscopic findings in renal transplant candidates

Giriş ve amaç: Helicobacter pylori enfeksiyonu peptik ülser, gastrik kanservgastrik MALT lenfoma ile yakın ilişkilendirilmiştir. Türkiyede normal böbrek fonksiyonu olan hastalarda Helicobacter pylori prevalansı yüksek olup Helicobacter pylori enfeksiyonu üst gastrointestinal sistem bulguları olan hastalarda majör risk faktörü olarak düşünülmektedir. Buna rağmen kronik böbrek yetmezlikli hastalarda Helicobacter pylorinin gastrointestinal mukozal lezyonlarla ilişkisi net olarak bilinmemektedir. Bu çalışmanın amacı böbrek nakli alıcı adaylarındaki endoskopik bulguları değerlendirmek, bu hastalardaki Helicobacter pylori prevalansını saptamak ve endoskopik bulgularla Helicobacter pylori prevalansı arasında ilişki olup olmadığını belirlemektir. Gereç ve Yöntem: Bu amaçla hastanemizde böbrek nakli yapılmış olan 64 hastanın nakilden hemen önceki hazırlık aşamasında yapılan endoskopik bulguları, endoskopik antrum biyopsilerinde hızlı üreaz testi ile saptanan Helicobacter pylori sıklığı analiz edilmiştir. Bulgular: Çalışmaya 64 hasta alınmıştır. Hastaların 41i (%64) erkek ve 23ü (%36) kadın hasta idi, hastaların yaş ortalaması 44.7±13.0 (18-67) olup, ortalama diyaliz süreleri 43,0±42,7 (6-189) ay idi, endoskopide 5 (%8) hastada gastrik veya duodenal ülser, 55 (%86) hastada gastrit, 1(%1.8) hastada özofajit, 8 (13%) hastada ise normal endoskopik bulgular izlenmiştir. Endoskopik antral biyopsilerde 9 (%14) hastada Helicobacter pylori pozitif, buna karşın 55 (%86) hastada Helicobacter pylori negatif saptanmıştır. Endoskopik bulgular arasında sadece gastrik veya duodenal ülser varlığı Helicobacter pylori enfeksiyonu ile istatistiksel olarak anlamlı olarak ilişkilendirilmiş diğer endoskopik bulgular ise Helicobacter pylori enfeksiyonu olan ve olmayan hastalarda benzer oranlarda görülmüştür. Diyaliz tipi ve diyaliz sürelerinin Helicobacter pylori varlığı ile ilişkisi bulunamamıştır. Sonuç: Böbrek nakli alıcı adaylarındaki Helicobacter pylori prevalansı normal topluma göre belirgin oranda düşüktür. Helicobacter pylori enfeksiyonu endoskopide yalnızca peptik ülser varlığı ile yakın ilişkilendirilmiş olup peptik ülser dışı endoskopik bulgular Helicobacter pylori dışı faktörler ile ilişkilendirilebilinir.

Böbrek nakli alıcı adaylarında Helicobacter pylori prevalansı ve endoskopik bulgularla ilişkisi

Background and Aims: Helicobacter pylori infection is closely associated with the development of peptic ulcers, gastric cancer and gastric MALT lymphoma. Its prevalence is high in patients with normal renal function in Turkey and is thought to be one of the major risk factors for gastrointestinal symptoms. It is unclear however, whether Helicobacter pylori infection is directly associated with gastrointestinal mucosal lesions in patients with chronic renal failure. Materials and Methods: The aim of this study was to evaluate the endoscopic findings of renal transplant candidates and to assess the prevalence of Helicobacter pylori infection. We retrospectively analysed the data of 64 renal transplant candidates endoscopies and antrum biopsy results for Helicobacter pylori infection. Results: Sixty-one patients were included in the study. Forty-one (64%) patients were male and 23 (36%) female; at the time of endoscopy mean patient age was 44.7±13.0 (range, 18- 67); mean duration of dialysis was 43.0±42.7 (range, 6-189) months; 5 (8%) patients had gastric or duedenal ulcers; 55 (86%) patients had gastritis; 1(1.8%) patient had esophagitis; and 8 (13%) patients had normal endoscopic findings. Endoscopic antral biopsy revealed that 9 (14%) patients were Helicobacter pylori positive, whereas 55 ( 86%) patients were Helicobacter pylori negative. Among the endoscopic findings, only peptic ulcer was closely associated with Helicobacter pylori infection. There was no correlationn between dialysis type or duration and the presence of Helicobacter pylori infection. Conclusions: Renal transplant candidates have significantly lower Helicobacter pylori prevalence than the normal population. Helicobacter pylori infection is closely associated with the presence of peptic ulcers in renal transplant candidates. There are factors other than Helicobacter pylori infection associated with esophagogastroduedenal lesions in patients with chronic renal failure.

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