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Prevalence of helicobacter pylori in chronic renal failure patients and its correlation with upper gastrointestinal endoscopic findings-a case control study

Author: 
K. C. Das, Sumeet David, Pardeep Kumar, Sanatan Behera, Rohit Roland and Sana Grace
Subject Area: 
Health Sciences
Abstract: 

Background: The gastrointestinal symptoms of anorexia, hiccups, nausea and vomiting are common early manifestations of CRF. Peptic ulcer disease is common in CRF patients, whether the high incidence is related to altered gastric acidity, hyper-secretion of gastrin or enhanced colonization by Helicobacter pylori (H.pylori) is still unknown. Aims: To study the prevalence of Helicobacter pylori in chronic renal failure patients as compared to a group of control subjects with normal renal function and to correlate the prevalence of Helicobacter pylori infection to upper gastrointestinal endoscopic findings. Setting and Design: Hospital based prospective Case-Control study. Materials & Methods: The patients were selected from the gastroenterology and Nephrology units Christian Medical College & Hospital, Ludhiana a tertiary care hospital to whom all subjected for endoscopy and for H. Pylori testing. Results: The presence of endoscopic antral gastritis showed significant association with H.pylori prevalence (57.6%) and (p<0.005), however, H.pylori infection was not related significantly to any other form of gastritis. Antral pattern of gastritis was the most common endoscopic lesion observed in both groups. The presence of duodenal ulcer or gastric ulcer did not show any increased prevalence of H.pylori. The combination of antral gastritis and duodenal ulcer showed 100 percent prevalence of H.pylori. There was no association found between H.pylori and reflux esophagitis. Gastric ulcer was seen in 3.2 percent cases and 3.6 percent controls. Duodenal ulcer was seen in 1.6 percent CRF patients and 20.4 percent controls. The commonest pattern of antral histology was active chronic superficial gastritis and was found in 33.3 percent cases and 44.9 percent controls. Both, controls and patients with CRF showed a similar pattern of histological gastritis. There was good correlation between endoscopic and histological gastritis. Conclusion: Gastrointestinal symptoms in patients with end stage kidney disease are due to multi-factorials, however high prevalence of H. Pylori infection is common in developing country like India where symptomatic patients need evaluation by doing U.G. I. Scopy where one should test and treat to alleviate the patients symptoms.

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