Endoscopic Evaluation and Helicobacter Pylori Prevalence in Dyspeptic Patients with Chronic Kidney Disease

Abstract

Abstract: Objective: Dyspepsia is a common symptom in chronic kidney disease (CKD) as well as in the normal population and may develop due to functional or organic causes. In the literature, there are different results about dyspepsia symptoms, upper gastrointestinal tract lesions and Hp prevalence in CKD. In this study, endoscopic findings and the prevalence of Helicobacter Pylori (Hp) in dyspeptic chronic kidney patients were investigated and compared with the normal population.

Materials & Methods: 67 patients with dyspeptic CKD (52 hemodialysis, 6 continuous ambulatory peritoneal dialysis, 9 predialysis) and 63 age and gender-matched control groups were included in our study. Gastrointestinal symptom scoring, upper endoscopic examination, histopathological examination of gastric antrum and corpus biopsies taken during this period, and rapid urease test (RUT) for Hp were performed on all cases included in the study.

Results: Gastrointestinal symptom scores were not different between the CKD and control groups (6.2±2.5 vs 7.7±3.6) (p>0.05). Although the prevalence of Hp in the CKD group (44.8%) was lower than the control group (54%) according to gastric biopsy findings, there was no difference between them (p>0.05). In the endoscopic examination, duodenal ulcer was more common in the control group and duodenitis in the CKD group, and the difference between them was significant (p<0.05). When compared with histopathological evaluation, the sensitivity (78% vs. 79%) and specificity (95% vs. 93%) of the urease test were similar in the CKD and control groups in both groups.

Conclusion: Gastrointestinal symptom score and Hp prevalence in chronic kidney disease were similar to the control group. No correlation was found between Hp and gastrointestinal symptom score. In the endoscopic examination, duodenal ulcer was more common in the control group and duodenitis was more common in the CKD group.