Effect of duration on hemodialysis on prevalence of Helicobacter pylori infection.

Digestive tract complications are common in hemodialysis (HD) patients, and
Helicobacter pylori (H. pylori) is thought to play an important role in the pathogenesis of gastrointestinal
mucosal lesions in these patients. Also, reports indicate that cytotoxin-associated gene A
(CagA) is the major factor involved in the pathogenesis of H. pylori disease. However, many
issues regarding H. pylori infection in HD patients are still unclear. In this cross-sectional study,
we investigated the effect of duration on HD on the prevalence of H. pylori infection and its
virulent CagA(+) strain. One-hundred and fifty-one HD patients who were referred to our
university HD center were included in the study. There were 78 males and 73 females, with a
mean age of 54.2 ± 14.6 years (range: 19–87 years). They were tested for serum anti-H. pylori IgG
antibody by the enzyme-linked immunosorbent assay method. Also, anti-CagA IgG antibody was
tested in H. pylori-infected patients. The study patients were categorized into two groups: shortterm
HD duration (STHD: ≤3 years) and long-term HD duration (LTHD: >3 years). The overall
prevalence of antibodies to H. pylori and CagA were 65.6% (99/151) and 25.3% (25/99), respectively.
The prevalence of H. pylori infection among the STHD and LTHD patients were 49/89
(55.10%) and 49/62 (79.0%), respectively; P <0.05. The prevalence of anti-CagA antibody in
infected STHD and LTHD patients was 24.5% (12/49) and 26.5% (13/49), respectively; P >0.05. Our
study suggests that the prevalence of H. pylori infection is higher in patients on LTHD. More
investigations are needed regarding the clinical consequences of H. pylori infection in HD patients.