Aralik 2014
Böbrek nakli alici adaylarinda Helicobacter pyloriprevalansi ve endoskopik bulgularla iliskisi
Helicobacter pyloriprevalence and its association with endoscopic findings in renal transplant candidates
- Ana Sayfa
- Sayılar
- Aralik 2014
- Böbrek nakli alici adaylarinda Helicobacter pyloriprevalansi ve endoskopik bulgularla iliskisi...
Özet
Giris ve amaç: Helicobacter pylorienfeksiyonu peptik ülser, gastrik kanser ve gastrik MALT lenfoma ile yakin iliskilendirilmistir. Türkiye’de normal böbrek fonksiyonu olan hastalarda Helicobacter pyloriprevalansi yüksek olup Helicobacter pylorienfeksiyonu üst gastrointestinal sistem bulgulari olan hastalarda majör risk faktörü olarak düsünülmektedir. Buna ragmen kronik böbrek yetmezlikli hastalarda Helicobacter pylori’ningastrointestinal mukozal lezyonlarla iliskisi net olarak bilinmemektedir. Bu çalismanin amaci böbrek nakli alici adaylarindaki endoskopik bulgulari degerlendirmek, bu hastalardaki Helicobacter pyloriprevalansini saptamak ve endoskopik bulgularla Helicobacter pyloriprevalansi arasinda iliski olup olmadigini belirlemektir. Gereç ve Yöntem: Bu amaçla hastanemizde böbrek nakli yapilmis olan 64 hastanin nakilden hemen önceki hazirlik asamasinda yapilan endoskopik bulgulari, endoskopik antrum biyopsilerinde hizli üreaz testi ile saptanan Helicobacter pylorisikligi analiz edilmistir. Bulgular:Çalismaya 64 hasta alinmistir. Hastalarin 41’i (%64) erkek ve 23’ü (%36) kadin hasta idi, hastalarin yas ortalamasi 44.7±13.0 (18-67) olup, ortalama diyaliz süreleri 43,0±42,7 (6-189) ay idi, endoskopide 5 (%8) hastada gastrik veya duodenal ülser, 55 (%86) hastada gastrit, 1(%1.8) hastada özofajit, 8 (13%) hastada ise normal endoskopik bulgular izlenmistir. Endoskopik antral biyopsilerde 9 (%14) hastada Helicobacter pyloripozitif, buna karsin 55 (%86) hastada Helicobacter pylorinegatif saptanmistir. Endoskopik bulgular arasinda sadece gastrik veya duodenal ülser varligi Helicobacter pylori enfeksiyonu ile istatistiksel olarak anlamli olarak iliskilendirilmis diger endoskopik bulgular ise Helicobacter pylorienfeksiyonu olan ve olmayan hastalarda benzer oranlarda görülmüstür. Diyaliz tipi ve diyaliz sürelerinin Helicobacter pylorivarligi ile iliskisi bulunamamistir. Sonuç: Böbrek nakli alici adaylarindaki Helicobacter pyloriprevalansi normal topluma göre belirgin oranda düsüktür. Helicobacter pylorienfeksiyonu endoskopide yalnizca peptik ülser varligi ile yakin iliskilendirilmis olup peptik ülser disi endoskopik bulgular Helicobacter pyloridisi faktörler ile iliskilendirilebilinir.
Abstract
Background and Aims: Helicobacter pyloriinfection is closely associated with the development of peptic ulcers, gastric cancer and gastric MALT lymphoma. Its prevalence is high in patients with normal renal function in Turkey and is thought to be one of the major risk factors for gastrointestinal symptoms. It is unclear however, whether Helicobacter pyloriinfection is directly associated with gastrointestinal mucosal lesions in patients with chronic renal failure. Materials and Methods:The aim of this study was to evaluate the endoscopic findings of renal transplant candidates and to assess the prevalence of Helicobacter pyloriinfection. We retrospectively analysed the data of 64 renal transplant candidates’ endoscopies and antrum biopsy results for Helicobacter pyloriinfection. Results: Sixty-one patients were included in the study. Forty-one (64%) patients were male and 23 (36%) female; at the time of endoscopy mean patient age was 44.7±13.0 (range, 18-67); mean duration of dialysis was 43.0±42.7 (range, 6-189) months; 5 (8%) patients had gastric or duedenal ulcers; 55 (86%) patients had gastritis; 1(1.8%) patient had esophagitis; and 8 (13%) patients had normal endoscopic findings. Endoscopic antral biopsy revealed that 9 (14%) patients were Helicobacter pyloripositive, whereas 55 ( 86%) patients were Helicobacter pylorinegative. Among the endoscopic findings, only peptic ulcer was closely associated with Helicobacter pylori infection. There was no correlationn between dialysis type or duration and the presence of Helicobacter pyloriinfection. Conclusions:Renal transplant candidates have significantly lower Helicobacter pylori prevalence than the normal population. Helicobacter pyloriinfection is closely associated with the presence of peptic ulcers in renal transplant candidates. There are factors other than Helicobacter pyloriinfection associated with esophagogastroduedenal lesions in patients with chronic renal failure.
