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Article Review/Hyperlink
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Luzza F, Imeneo M, Maletta M, Mantelli I, Tancre D, Merando
G, Biancone L, Pallone F
Helicobacter pylori-specific IgG in chronic
haemodialysis patients: Relationship of hypergastrinaemia to
positive serology
Nephrol Dial Transplant
(Jan) 11:120-124 1996

We know the Helicobacter pylori metabolize urea, and that they cause
duodenal ulcers, atrophic gastritis, and possibly gastric tumors. Gastrin
levels also are increased in H. pylori positive patients. This study
examined the role of H. pylori infection in unselected hemodialysis
patients (although 30% of them were on H2 blockers!). An ELISA test was
developed using an H. pylori isolate from local patients. This
enables quantification of IgG specific against H. pylori.
The prevalence of patients with positive IgG antibody to H. pylori was
very high (54-80%) in both dialysis patients and controls (60-85%). There
was no association among common GI symptoms (hunger pangs, bloating,
epigastric pain) and IgG positivity. However, gastin levels averaged 600
ng/ml in IgG positive patients vs. 300 ng/ml in IgG negative patients. In
controls gastrin levels averaged 56 and 37 ng/ml in IgG-positive and negative
patients, respectively.
The conclusions of the study are that H. pylori infection contributes
to the hypergastinemia found in dialysis patients, although this means a 20-
fold vs a 10-fold elevation. Whether this is clinically important is
dubious. Whether dialysis patients with peptic ulcer disease receive the
same benifit from H. pylori eradication as their non-uremic
counterparts remains an open clinical question. (John T. Daugirdas MD,
University of Illinois at Chicago)
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