Upper gastrointestinal disorders and Helicobacter pylori infection in renal transplant recipients
Abstract
It is well known that Helicobacter pylori (Hp) plays a significant role in etiology and pathogenesis of upper gastrointestinal disorders. Patients with terminal Renal Failure treated with haemodialysis (HD) and renal transplant recipients often suffer from gastrointestinal disorders. However the role of Hp in pathogenesis of gastrointestinal complaints remains quite contradictory. The goal of this study is to define correlation between the Hp infection and gastrointestinal complaints in renal transplant recipients. 30 renal transplant recipients were included in this study. Upper gastrointestinal endoscopies were performed in all patients. 23 patients underwent gastric antral biopsies for morphological Hp detection. Serum antibodies to Hp were studied in 29 patients. From these 29 patients 9 (31%) were Hp positive. As a result of morphological test 20 (87%) of 23 patients were found to be Hp positive. Based on the results we conclude that persistence of Hp is one of the most important mechanisms of gastrointestinal disorders in renal transplant recipients. Therefore antibacterial agents with anti-Hp activity should be a routine part of the treatment protocol of early posttransplantation period in these patients.
About the Authors
V. A. Anashkin
Центральный клинико-диагностический комплекс ГУ НМХЦ МЗ РФ, Российский государственный медицинский университет, г. Москва
Russian Federation
Russian Federation
D. V. Perlin
Центральный клинико-диагностический комплекс ГУ НМХЦ МЗ РФ, Российский государственный медицинский университет, г. Москва
Russian Federation
Russian Federation
N. N. Khasabov
Центральный клинико-диагностический комплекс ГУ НМХЦ МЗ РФ, Российский государственный медицинский университет, г. Москва
Russian Federation
Russian Federation
A. V. Yakovenko
Центральный клинико-диагностический комплекс ГУ НМХЦ МЗ РФ, Российский государственный медицинский университет, г. Москва
Russian Federation
Russian Federation
E. P. Yakovenko
Центральный клинико-диагностический комплекс ГУ НМХЦ МЗ РФ, Российский государственный медицинский университет, г. Москва
Russian Federation
Russian Federation
B. I. Obukhovsky
Центральный клинико-диагностический комплекс ГУ НМХЦ МЗ РФ, Российский государственный медицинский университет, г. Москва
Russian Federation
Russian Federation
References
1. Аруин Л.И., Григорьев П.Я., Исаков В.А., Яковенко Э.П. Хронический гастрит. Амстердам: 1993: 382.
2. Васильев Ю.В., Касьяненко В.И. Семидневная антихеликобактерная терапия язвенной болезни двенадцатиперстной кишки, ассоциированной с Helicobacter pylori, и перспективы лечения больных. Экспериментальная и клиническая гастроэнтерология 2002; 3: 26-28.
3. Григорьев П.Я. Helicobacter pylori: гастрит, дуоденит, язвенная болезнь. Практикующий врач 1999; 16 (3): 3-6.
4. Щербаков П.Л. Эпидемиология инфекции Helicobacter pylori. Helicobacter pylori: революция в гастроэнтерологии. Ивашкин В.Т., Мегро Ф., Лапина Т.Л. М.: Триада-Х 1999; 14-20.
5. Ala-Kaila K. Upper gastrointestinal findings in chronic renal failure. Scand J Gastroenterol 1987; 22: 372-376.
6. Bayerdoerffer E., Miehlke S., Lehn E. et al. Chronic type B gastritis as an important denominator of peptic ulcer healing. Eur J Gastroenterol 1993; 5: 99-105.
7. Davenport A., Shallcross T., Grabtree J. Prevalence of Helicobacter pylori in patients with end stage renal failure and renal transplant recipients. Nephron 1991; 59: 587-601.
8. Glupczynski Y. Microbiological and serological diagnostic tests for Helicobacter pylori: an overview. Acta Gastroenterol Belg 1998; 61: 321-325.
9. Gomez V., Burgos J., Rivera M. et al. Gastrointestinal complications in renal transplantation. Actas Urol Esp 1994; 18: 277-280.
10. Grabtree J. Gastric mucosal inflammatory responses to Нelicobacter pylori. Aliment Pharmacol Ther 1996; 10: 29-37.
11. Graham D., Go M. Helicobacter pylori. Current status. Gastroenterology 1993; 105: 279-282.
12. Jaspersen D., Fassbinder W., Heinkell P. et al. Significantly lower prevalence of Нelicobacter pylori in uremic patients than in patients with normal renal function. J Gastroenterol 1995; 30: 585-588.
13. Jaspersen D., Koemer T., Schorr W. et al. Нelicobacter pylori eradication reduces the rate of rebleeding in ulcer hemorrhage. Gastrointest Endosc 1995; 41: 4-7.
14. Kang J. Peptic ulcer in hepatic cirrhosis and renal failure. J Gastroentero Hepatol 1994; (Suppl): 20-23.
15. Kashiwagi T., Iino Y., Sakaki N. et al. Importance of Нelicobacter pylori infection pepsinogen titer in hemodialysis and renal transplant patients in Japan. Nippon Jinzo Gakkai Shi 1994; 36: 853-857.
16. Mendall M., Goggin D., Molineaux N. Childhood living conditions and Helicobacter pylori seropositivity in adult life. Lancet 1992; 339: 896-897.
17. Ozgur O., Boyacioglu S., Ozdogan M. et al. Helicobacter pylori in haemodialysis patients and renal transplant recipients. Nephrol Dial Transplant 1997; 12: 289-291.
18. Parsonner J., Fridman G., Vandersteen D. et al. Helicobacter pylori and the risk of gastric cancer. N Engl J Med 1991; 325: 1127-1131.
19. Sari R., Ozen S., Aydogdu I. et al. The pathological examinations of gastric mucosa in patients with Нelicobacter pylori - positive and - negative pernicious anemia. Helicobacter 2000; 5; 4: 215-221.
20. Teenan R., Burgayne M., Brown I. et al. Helicobacter pylori in renal transplant patients. Transplantation 1993; 56: 100-103.
21. Tytgat G.N.T. Can mucosal damage in gastroesophageal relux disease be graded endoscopically? The esophagogastric Junction. Ed. by R. Giuli et al. Paris: John Libbey Eurotext 1998: 525-527.
22. Wee A., Kang J., Ho M. Gastrointestinal mucosa in uremia: endoscopic and histological correlation and prevalence of Нelicobacter like organisms. Gut 1991; 31: 1093-1096.
Review
For citations:
Anashkin V.A., Perlin D.V., Khasabov N.N., Yakovenko A.V., Yakovenko E.P., Obukhovsky B.I. Upper gastrointestinal disorders and Helicobacter pylori infection in renal transplant recipients. Nephrology and Dialysis. 2003;5(4):357-361. (In Russ.)
Views:
12
Email this article 