HDCN Article Review/Hyperlink

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)