단일기관에서 소화성 궤양을 진단 받은 투석 환자의 Helicobacter pylori 유병률

초록

Purpose: Patients with chronic renal failure tend to have an increased incidence of peptic ulcer disease. Helicobacter pylori (H. pylori) infection is generally found to be the major cause of peptic ulcer disease. There are a few studies about the association between H. pylori and peptic ulcer disease in dialysis patients. In this retrospective study, we investigated the relationship between H. pylori and peptic ulcer disease in dialysis patients. Methods: The participants enrolled in this study were hemodialysis (HD) or peritoneal dialysis (PD) patients in the period from February 2001 to March 2010, who had been diagnosed as having a peptic ulcer. The presence of H.pylori was identified by at least one of the following: the rapid urease test, the urea breath test or histologic findings. Results: A total of 132 patients (100 HD and 32 PD patients) were enrolled. The mean age and duration of dialysis were 56.5±14.8 years and 27.6±45.3 months, respectively. The prevalence of H. pylori- positive patients amongst those with peptic ulcer disease was 43.1% (57/132). H. pylori-positive prevalence was 48.1% (38/79) in gastric ulcer patients, and 33.3% (11/33) in duodenal ulcer patients, but this difference was not significant (p=0.21). There were no significant differences in age, causes of chronic renal failure or dialysis method between the H. pylori-positive and H. pylori-negative groups. However, the duration of dialysis was significantly longer in the H. pylori-negative group (16.6±34.1 vs. 36.0±50.8 months, p=0.01). Furthermore, as the duration of dialysis increased, the prevalence of H. pylori infection decreased (p=0.004). Conclusion: There was little association between H. pylori and peptic ulcer disease in dialysis patients. Long-term dialysis appeared to decrease the prevalence of H. pylori infection in peptic ulcer disease.

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