Helicobacter pylori in patients with advanced chronic renal failure

Abstract EN

Ammonia generated by the action of urease producing organism(s) on urea is generally held responsible for the gastrointestinal symptoms of uremia, however, little information is available on the exact organism(s) responsible.

We have studied prospectively 70 consecutive patients with moderate or severe degree of chronic renal failure for the presence of Helicobacter pylori (H.

pylori) infection of the gastric and duodenal mucosa using bacteriological and histological methods.

All patients were endoscoped for presence of gastroduodenal mucosal lesions and graded for the severity of uremia related gastrointestinal symptoms.

Uremic symptoms of varying severity were present in all the patients, while H.

pylori was present in 81.4% and gastroduodenal erosions and/or ulcers were in 53% of them.

No direct correlation was demonstrated between H.

pylori infection of the gastroduodenal mucosa, endoscopic findings and presence or severity of uremia related gastrointestinal symptoms.

It is concluded that H.

pylori is present in the gastroduodenal mucosa of a large number of patients with advanced renal failure however, it does not appear to play a causative role in gastritis or dyspeptic symptoms associated with uremia.

Histological examination provided a higher yield over microbiological methods in demonstrating H.

pylori infection of gastroduodenal mucosa.