Helicobacter pyloriprevalence and its association with endoscopic findings in renal transplant candidates

Öz

Background and Aims: Helicobacter pyloriinfection 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 pyloriinfection 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 pyloriinfection. We retrospectively analysed the data of 64 renal transplant candidates' endoscopies and antrum biopsy results for Helicobacter pyloriinfection. 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 pyloripositive, whereas 55 ( 86%) patients were Helicobacter pylorinegative. 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 pyloriinfection. Conclusions:Renal transplant candidates have significantly lower Helicobacter pylori prevalence than the normal population. Helicobacter pyloriinfection is closely associated with the presence of peptic ulcers in renal transplant candidates. There are factors other than Helicobacter pyloriinfection associated with esophagogastroduedenal lesions in patients with chronic renal failure.

Anahtar Kelimeler

• Helicobacter pylori,chronic renal failure, renal transplantation

Böbrek nakli alıcı adaylarında Helicobacter pyloriprevalansı ve endoskopik bulgularla ilişkisi

Öz

Giriş ve amaç: Helicobacter pylorienfeksiyonu peptik ülser, gastrik kanser ve gastrik MALT lenfoma ile yakın ilişkilendirilmiştir. Türkiye'de normal böbrek fonksiyonu olan hastalarda Helicobacter pyloriprevalansı yüksek olup Helicobacter pylorienfeksiyonu üst gastrointestinal sistem bulguları olan hastalarda majör risk faktörü olarak düşünülmektedir. Buna rağmen kronik böbrek yetmezlikli hastalarda Helicobacter pylori'ningastrointestinal mukozal lezyonlarla ilişkisi net olarak bilinmemektedir. Bu çalışmanın amacı böbrek nakli alıcı adaylarındaki endoskopik bulguları değerlendirmek, bu hastalardaki Helicobacter pyloriprevalansını saptamak ve endoskopik bulgularla Helicobacter pyloriprevalansı 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 pylorisıklığı analiz edilmiştir. Bulgular:Çalışmaya 64 hasta alınmıştır. Hastaların 41'i (%64) erkek ve 23'ü (%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 pyloripozitif, buna karşın 55 (%86) hastada Helicobacter pylorinegatif saptanmıştır. Endoskopik bulgular arasında sadece gastrik veya duodenal ülser varlığı Helicobacter pylori enfeksiyonu ile istatistiksel olarak anlamlı olarak ilişkilendirilmiş diğer endoskopik bulgular ise Helicobacter pylorienfeksiyonu olan ve olmayan hastalarda benzer oranlarda görülmüştür. Diyaliz tipi ve diyaliz sürelerinin Helicobacter pylorivarlığı ile ilişkisi bulunamamıştır. Sonuç: Böbrek nakli alıcı adaylarındaki Helicobacter pyloriprevalansı normal topluma göre belirgin oranda düşüktür. Helicobacter pylorienfeksiyonu endoskopide yalnızca peptik ülser varlığı ile yakın ilişkilendirilmiş olup peptik ülser dışı endoskopik bulgular Helicobacter pyloridışı faktörler ile ilişkilendirilebilinir.

Anahtar Kelimeler

• Helicobacter pylori, kronik böbrek yetmezliği, böbrek nakli

Kaynakça

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