# Helicobacter pylori as a Cause of Dyspepsia in Patients With End-Stage Renal Disease

## TL;DR

This study found that Helicobacter pylori is a common cause of dyspepsia in patients with end-stage renal disease, suggesting that screening and treatment could improve their quality of life.

## Contribution

The study identifies H. pylori as a significant cause of dyspepsia in end-stage renal disease patients, a population where its role was previously unclear.

## Key findings

- 40% of ESRD patients with dyspepsia tested positive for H. pylori.
- H. pylori infection was significantly associated with diabetes, hypertension, NSAID use, postprandial fullness, and epigastric pain.
- Longer hemodialysis duration was linked to lower H. pylori prevalence.

## Abstract

Introduction

Dyspepsia is a frequent complaint in patients with end-stage renal disease (ESRD). Helicobacter pylori (H. pylori) is a well-established etiological factor for dyspepsia in the general population; however, its role in ESRD patients remains to be determined. Therefore, this study aimed to determine the frequency of H. pylori infection among ESRD patients presenting with dyspeptic symptoms.

Methodology

A cross-sectional study was conducted at the Sindh Institute of Urology and Transplantation from January 2023 to June 2024. A total of 200 adult ESRD patients undergoing maintenance hemodialysis and experiencing dyspepsia for at least three months were included. The patients with history of H. pylori infection or prior history of H. pylori eradication, those with history of usage of proton pump inhibitors or antibiotics or H2-receptor blockers within the past month, patients with gastric or duodenal ulcers, gastrointestinal malignancies or other systemic diseases causing dyspepsia and pregnant or breastfeeding females were excluded from the study. Upper gastrointestinal endoscopy and gastric biopsies were performed for histological confirmation of H. pylori. Data were analyzed using SPSS (IBM SPSS Statistics for Windows, IBM Corp., Version 27, Armonk, NY).

Results

Out of 200 patients, 80 (40%) were positive for H. pylori. Significant associations were observed between H. pylori infection and diabetes (p = 0.036), hypertension (p = 0.043), NSAID usage (p = 0.024), postprandial fullness (p ≤ 0.001), and epigastric pain (p = 0.041). Inversely, longer hemodialysis duration was associated with a lower prevalence of H. pylori (p = 0.012). Patients with H. pylori had lower hemoglobin and BMI levels and higher total leukocyte counts.

Conclusion

Our study showed that H. pylori is a common cause of dyspepsia in the ESRD population. Screening and eradication strategies may improve symptom control and enhance quality of life in this population. Multi-centered studies with larger sample sizes are not only required to validate our results but also to assess therapeutic outcomes.