Association between Helicobacter pylori infection and the subsequent risk of end-stage renal disease: a nationwide population-based cohort study

Acute Helicobacter pylori Infection Prevalence Among Renal Failure Patients and Its Potential Roles with Other Chronic Diseases: A Retrospective Cohort Study

Background

Helicobacter pylori (H. pylori) infection is relevant to several chronic human diseases, from digestive diseases to renal, metabolic, and cancer diseases. H. pylori infections and chronic kidney diseases are in increasing, global records; if not well controlled in a specific population, these diseases might lead to more clinical complications.

Methods

In this retrospective study, we investigated the prevalence of acute H. pylori infections among 127 dialysis patients via subjecting their serums to the enzyme-linked immunosorbent assay (ELISA) to detect the human Immunoglobulin M (IgM) against H. pylori infections. Samples were from dialysis patients in a single hemodialysis center in Medina, Saudi Arabia, from January to August 2021.

Results

Our results indicated the significant prevalence of H. pylori acute infections among 33.1% of renal failure patients recruited in this study, chi-squared: 14.559, p-value: 0.0001. In addition, no significant occurrence of acute H. pylori infection among males and females, chi-squared: 1.823, p-value: 0.177. Furthermore, the prevalence of acute H. pylori infection was not significant in different age groups of renal failure patients. Chi-squared: 6.803, p-value: 0.147, despite H. pylori-infected cases predominantly represented in patients above 51 years. Moreover, we noticed that hypertension, followed by diabetes, was the most prevalent underlying medical condition among acute infected H. pylori and renal failure patients.

Conclusion

We documented the significant prevalence of acute H. pylori infection among renal failure patients. We also highlighted and discussed the possible potential roles of H. pylori in renal failure and other chronic diseases. Routine screening and treatment for acute H. pylori infection for chronic kidney diseases, hypertension, and diabetes patients would positively reduce the bacterium’s progressive effects on them. They might even improve the control of these diseases.

Association Between Helicobacter pylori Eradication and Kidney Function in Patients With Chronic Gastritis: A Retrospective Single-Center Study

Background

Helicobacter pylori (HP) is a common bacterium that globally infects humans. The significance of HP infection and eradication of kidney impairment remain ambiguous. Moreover, little is known about whether elimination of the bacteria has any consequence on kidney function. This study aimed to explore the relationship between HP eradication and kidney function in patients with chronic gastritis (CG).

Methodology

We retrospectively reviewed the records of all CG patients with eradicated HP at King Abdulaziz University Hospital between June 2002 and June 2021. All patients older than 18 years, diagnosed with CG in whom HP had been eradicated, were included. Out of 1,936 patients’ records, only 46 met the criteria.

Results

The mean age of the study sample was 48 years; in addition, 58.7% of the patients were obese. There was no significant difference in serum creatinine, blood urea nitrogen, and glomerular filtration rate after HP eradication (P-values of 0.414, 0.112, and 0.300, respectively).

Conclusions

We found no relationship between the eradication of HP and improvement in renal function. However, prospective population-based studies must be conducted to assess an association between HP eradication and renal function, as well the future risk of nephropathy with the persistence of HP. As such, we recommend a multicenter study that includes a representative sample size.

Relationship Between Helicobacter pylori Infection and Arteriosclerosis

It is reported that Helicobacter pylori (H. pylori) infection may be linked to non-digestive tract diseases, such as arteriosclerosis including dyslipidemia, diabetes, obesity, hypertension, and cardiovascular disease. Therefore, we reviewed recent studies available in PubMed dealing with the mechanisms of arteriosclerosis due to H. pylori infection and the effects of H. pylori eradication. Conventional studies suggested that H. pylori infection may increase the risk of arteriosclerosis. A large interventional study is required to clarify the causal relationships and the effects of bacterial eradication.

Assessing the Relationship between Helicobacter pylori and Chronic Kidney Disease

The relationship between Helicobacter pylori infection and/or gastric disorders and chronic kidney disease (CKD) has not been elucidated. We investigated the relationship between Helicobacter pylori and/or atrophic gastritis (AG) and chronic kidney disease. In total, 3560 participants (1127 men and 2433 women) were eligible for this cross-sectional study. We divided participants into four study groups: with/without Helicobacter pylori infection and with/without AG. The HP (+) AG (−) group demonstrated a significant association with CKD compared with the HP (−) AG (−) group (adjusted odds ratio, 1.443; 95% confidence interval, 1.047–1.989). In contrast, the HP (+) AG (+) group showed significantly lower adjusted odds of CKD than the HP (−) AG (−) group (adjusted odds ratio, 0.608; 95% confidence interval, 0.402–0.920). H. pylori infection without AG might be associated with CKD in these participants. Conversely, the HP (+) AG (+) group had lower odds of CKD. Uncovering an association between gastric and renal conditions could lead to development of new treatment strategies.

Association between Helicobacter pylori infection and kidney damage in patients with peptic ulcer

Background:Helicobacter pylori (H. pylori) is relevant to several renal diseases. Our previous research indicates that cytotoxin-associated gene A (CagA) of H. pylori increases secretion of serum immunoglobulin A1 (IgA1) and induces the underglycosylation of IgA1, one of the key factors causing IgA nephropathy. Here, we aimed to study the correlation between H. pylori infection and kidney damage in patients with peptic ulcer, and evaluate the effect of H. pylori eradication on kidney damage.

Methods:¹⁴C-urea breath test and rapid urease tests were applied to H. pylori infection detection. Random urine samples are subjected to the albumin–creatinine ratio (ACR) examination. The correlation between ACR and H. pylori infection was analyzed in patients with peptic ulcer and healthy controls. The levels of IgA and underglycosylated IgA1 in serum are also detected by enzyme-linked immunosorbent assay (ELISA) and Helix aspersa lectin (HAA) binding assay.

Results: (1) H. pylori infection rate in patients with peptic ulcer (88.14%) is significantly higher than that in healthy controls (42.68%). (2) There is a positive correlation between H. pylori infection and ACR abnormal in patients with peptic ulcer (p = .025), while showing a negative correlation in healthy individuals (p = .571). (3) Urinary ACR was uncorrelated with the severity of H. pylori infection in the 27 abnormal urinary ACR cases of the patients with peptic ulcer. (4) After H. pylori eradication, the ACR rates of H. pylori-positive patients with peptic ulcer were significantly decreased (p<.01).

Conclusions: (1) For the H. pylori-positive patients with peptic ulcer, H. pylori infection may be a risk factor resulting in kidney damage. (2) H. pylori eradication probably benefits to kidney damage relief and chronic kidney disease prevention.

Role of Helicobacter pylori infection in the manifestation of old age-related diseases

Helicobacter pylori is one of the most prevalent infection worldwide. It affects individuals of different age groups. Elderly people tend to resist eradication treatment and worsening of infection can lead to several gastric and non-gastric pathologies. Aging-associated cellular and molecular alteration can increase the risk of other pathologies such as osteoporosis, Alzheimer's disease, Parkinson's disease, respiratory and renal dysfunction, and cancer in geriatric patients, more than other age groups. This review article highlights some of the most common old age diseases and the role of H. pylori infection as a risk factor to worsen the conditions, presented by the molecular evidences of these associations. These studies can help clinicians to understand the underlying pathogenesis of the disease and identify high-risk patients, aiding clearer diagnosis and treatment.

Helicobacter pylori, Endoscopic, And Histologic Features Among Kidney Transplant Candidates In Southern Iran

Background

The risks of gastrointestinal disorders and cancer are higher in chronic kidney disease (CKD) patients than the general population. There are only a few published reports on the association of helicobacter pylori (H. pylori) infection, endoscopic findings, and histology in these patients. This study was designed to address these controversial topics among kidney transplant candidates as the first study in southern Iran.

Patients and methods

In this cross-sectional study, patients undergoing renal transplantation in the largest center of southern Iran during 2016–2017 were evaluated for the frequency of H. pylori infection, endoscopic findings, and histology. Gastric endoscopic findings (normal, abnormal non-ulcerative, ulcerative) and histological findings of gastric biopsy (normal/non-significant, inflammation, premalignant lesions (PMLs), malignant lesions) were studied.

Results

In total, 293 patients underwent endoscopy for transplant work up. The mean age (SD) was 47.37 (13.14) years. The most common endoscopic finding was abnormal gastric lesions. Overall, 78.8% patients had abnormal gastric histologic findings, of which 6.1% had PMLs. There was no significant association between laboratory data of patients with H. pylori infection. Of these, 147 (50.2%) patients were positive and the others were H. Pylori negative. Positive H. pylori infection was significantly associated with gastric ulcerative lesions. Positive H. pylori infection was also strongly associated with inflammation (P<0.01), but not significantly associated with PMLs (P=0.99) in gastric histology.

Conclusion

The present study showed that abnormal endoscopic and histologic findings as well as positive H. pylori infection were observed in a large number of kidney transplant candidates, so upper endoscopy with biopsy is an acceptable procedure for these patients. However, further studies are recommended to determine the relationship of H. pylori with abnormal endoscopic and histologic findings considering other confounding factors in kidney transplant candidates as well as the efficacy of H. pylori eradication therapy to improve these abnormal findings.

Association of Arrhythmia in Patients with Cervical Spondylosis: A Nationwide Population-Based Cohort Study

BACKGROUND

Sympathetic activity, including cervical ganglia, is involved in the development of cardiac arrhythmias.

OBJECTIVE

The present study investigated the association between cervical spondylosis and arrhythmia, which has never been reported before.

METHODS

Patients newly diagnosed with cervical spondylosis (CS) with an index date between 2000 and 2011 were identified from the National Health Insurance Research Database. We performed a 1:1 case-control matched analysis. Cases were matched to controls according to their estimated propensity scores, based on demographics and existing risk factors. Cox proportional hazard models were applied to assess the association between CS and arrhythmia.

RESULTS

The CS cohort comprised 22,236 patients (males, 42.6%; mean age, 54.4 years) and non-CS cohort comprised 22,236 matched controls. There were 1441 events of arrhythmia in CS cohort and 537 events of arrhythmia in non-CS cohort, which 252 and 127 events of atrial fibrillation in CS and non-CS cohort, 33 and 12 events of ventricular tachycardia in CS cohort and non-CS cohort, 78 and 35 events of supraventricular tachycardia in CS cohort and non-CS cohort. The CS cohort had an arrhythmia incidence of 11.1 per 1000 person-years and a higher risk [adjusted hazard ratio (aHR) = 3.10, 95% confidence interval (CI) = 2.80⁻3.42] of arrhythmia, 2.54-fold aHR of ventricular tachycardia (95% CI = 1.70⁻3.79), and 2.22-fold aHR of atrial fibrillation (95% CI = 1.79⁻2.76) compared with non-CS cohort.

CONCLUSIONS

Cervical spondylosis is associated with a higher risk of arrhythmia.

Association between Helicobacter pylori and end-stage renal disease: A meta-analysis

AIM

To investigate the prevalence and association of Helicobacter pylori (H. pylori) with end-stage renal disease (ESRD).

METHODS

SA comprehensive literature search was completed from inception until October 2016. Studies that reported prevalence, relative risks, odd ratios, hazard ratios or standardized incidence ratio of H. pylori among ESRD patients were included. Participants without H. pylori were used as comparators to assess the association between H. pylori infection and ESRD. Pooled risk ratios and 95%CI was calculated using a random-effect model. Adjusted point estimates from each study were combined by the generic inverse variance method of DerSimonian and Laird.

RESULTS

Of 4546 relevant studies, thirty-seven observational studies met all inclusion criteria. Thirty-five cross-sectional studies were included in the analyses to assess the prevalence and association of H. pylori with ESRD. The estimated prevalence of H. pylori among ESRD patients was 44% (95%CI: 40%-49%). The pooled RR of H. pylori in patients with ESRD was 0.77 (95%CI: 0.59-1.00) when compared with the patients without ESRD. Subgroup analysis showed significantly reduced risk of H. pylori in adult ESRD patients with pooled RR of 0.71 (95%CI: 0.55-0.94). The data on the risk of ESRD in patients with H. pylori were limited. Two cohort studies were included to assess the risk of ESRD in patients with H. pylori. The pooled risk RR of ESRD in patients with H. pylori was 0.61 (95%CI: 0.03-12.20).

CONCLUSION

The estimated prevalence of H. pylori in ESRD patients is 44%. Our meta-analysis demonstrates a decreased risk of H. pylori in adult ESRD patients.

Association of H. pylori infection with chronic kidney disease among Chinese adults

BACKGROUND

Some studies have suggested that Helicobacter pylori (H. Pylori) infection was associated with insulin resistance and metabolic syndrome, which may increase the risk of chronic kidney disease (CKD). But there is no conclusive evidence regarding the association between H. Pylori infection and CKD. To help clarify this, we conducted the cross-sectional study to investigate the association of H. pylori infection with CKD among Chinese adults.

METHODS

A total of 22,044 adults aged 48.6 ± 14.3 years were enrolled. H. pylori-specific immunoglobulin G antibody titers were measured by ELISA. CKD was defined as estimated glomerular filtration rate (eGFR) less than <60 ml/min/1.73 m² or presence of proteinuria (urine protein ≥ 1+) assessed using a repeated dipstick method.

RESULTS

Among all participants in this study, the prevalence of H. Pylori infection was 20.6%. As a categorical outcome, the prevalence of decreased eGFR in the H. Pylori infection group was higher than in the non-H. Pylori infection group (1.6 vs. 1.2%, P = 0.04), but the prevalence of proteinuria and the overall CKD were not significantly different between these two groups (1.7 vs. 1.6%, P = 0.65 and 3.0 vs. 2.7%, P = 0.2). After adjusted for age, sex, hypertension, diabetes, body mass index, uric acid, smoking, drinking, total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, the odds of decreased eGFR and proteinuria were not significantly different between the H. Pylori positive and negative subjects.

CONCLUSIONS

This study did not find an association between H. Pylori infection and CKD.

The Association of Helicobacter pylori Eradication with the Occurrences of Chronic Kidney Diseases in Patients with Peptic Ulcer Diseases

The association of Helicobacter pylori eradication with the occurrence of renal dysfunction in patients with peptic ulcer diseases is still unclear. This study aimed to clarify the relevance of H. pylori eradication to the occurrence of chronic kidney diseases in patients with peptic ulcer diseases. Data that were available from 2000–2011 were extracted from the National Health Insurance Research Database in Taiwan, and all patients with peptic ulcer diseases (n = 208 196) were screened for eligibility. We divided randomly selected patients into an H. pylori eradication cohort (cohort A, n = 3593) and matched them by age and sex to a without H. pylori eradication cohort (cohort B, n = 3593). Subgroup analysis was further performed for H. pylori eradication within ≤ 90 days of the diagnosis date (early eradication, n = 2837) and within 91–365 days (non-early eradication, n = 756). Cox proportional hazards regression analysis was used to estimate the association of H. pylori eradication with the risk of developing chronic kidney diseases and mortality. We observed that there were more patients suffering from chronic kidney disease in cohort B than in the early eradication subgroup of cohort A (8.49% vs. 6.70%, respectively, p = 0.0075); the mortality rate was also higher in cohort B (4.76% vs. 3.70%, respectively, p = 0.0376). Old age, pulmonary disease, connective tissue disorders, and diabetes were risk factors for chronic kidney diseases but early H. pylori eradication was a protective factor against chronic kidney diseases (hazard ratio: 0.68, 95% confidence interval: 0.52–0.88, p = 0.0030), and death (hazard ratio: 0.69, 95% confidence interval: 0.49–0.96, p = 0.0297). In conclusion, our findings have important implications suggesting that early H. pylori eradication is mandatory since it is associated with a protective role against the occurrence of chronic kidney diseases.

Analysis of Patients with Helicobacter pylori Infection and the Subsequent Risk of Developing Osteoporosis after Eradication Therapy: A Nationwide Population-Based Cohort Study

Purpose

Previous studies have reported conflicting results on the association between Helicobacter pylori infection and osteoporosis. A few studies have discussed the influence of H. pylori eradication therapy on bone mineral density.

Methods

We assessed the prevalence of osteoporosis among the H. pylori-infected population in Taiwan and the influence of early and late H. pylori eradication therapy on bone mineral density.

Results

Using data from Taiwan's National Health Insurance Research Database, we identified 5,447 patients who received H. pylori eradication therapy from 2000 to 2010 and 21,788 controls, frequency-matched according to age, sex, and year of receiving H. pylori eradication therapy. Those who received H. pylori eradication therapy were divided into two groups based on the time interval between the diagnosis of a peptic ulcer and commencement of eradication therapy. The risk of developing osteoporosis was higher in the early H. pylori treatment cohort (hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.23–1.89) and late H. pylori treatment cohort (HR = 1.69, 95% CI = 1.39–2.05), compared with the risk in the control cohort. When followed for less than 5 years, both the early and late cohorts had a higher risk of developing osteoporosis (HR = 1.69, 95% CI = 1.32–2.16 and HR = 1.72, 95% CI = 1.38–2.14). However, when the follow-up period was over 5 years, only the late eradication group exhibited a higher incidence of osteoporosis (HR = 1.62, 95% CI = 1.06–2.47).

Conclusion

The development of osteoporosis is complex and multi-factorial. Via this population-based cohort study and adjustment of possible confounding variables, we found H. pylori infection may be associated with an increased risk of developing osteoporosis in Taiwan. Early eradication could reduce the influence of H. pylori infection on osteoporosis when the follow-up period is greater than 5 years. Further prospective studies are necessary to discover the connection of H. pylori and osteoporosis.

Association of statin use and the risk of end-stage renal disease: A nationwide Asian population-based case-control study

BACKGROUND

Although experimental models have shown that statins could alleviate glomerular damage and decrease urinary protein excretion, the renal effects of statins remain unclear. A case-control study was conducted using data from Taiwan's National Health Insurance system.

METHODS

An end-stage renal disease (ESRD) group comprising 11,486 patients was established. Each patient was frequency-matched by age, sex, and comorbidities with one person without ESRD from the general population. Logistic regression analysis was performed to estimate the influence of statin use on ESRD risk.

RESULTS

The overall adjusted odds ratios (ORs) of ESRD among patients who received statins was 1.59 (95% confidence interval=1.50-1.68). The raised ESRD risk of statin remained consolidated regardless of statin type (P<.001), except lovastatin. Further, while stratified by cumulative define daily dose, the risk of ESRD increased with accumulative dosage of statins (P for trend<.001).

CONCLUSION

This population-based case-control study showed that statin use might be associated with increased ESRD risks. Large-scale randomized clinical trial encompassing statins of different kinds and populations of different comorbidities would be helpful to clarify the potential ESRD risks of statin users.

Association Between Chronic Osteomyelitis and Risk of End-Stage Renal Disease: A Nationwide Population-Based Cohort Study

Inflammation, which initiates endothelial dysfunction, vascular atherosclerosis, and oxidative stress, may negatively influence renal function and accelerate the development of end-stage renal disease (ESRD). The role of chronic osteomyelitis (COM), a chronic inflammatory disease, in the development of ESRD has not been investigated. This study explored whether patients with COM have a higher risk of ESRD than that of patients without COM.Taiwan National Health Insurance claims from 1997 to 2010 were used to identify 24,267 newly diagnosed patients with COM and 97,068 age- and sex-matched non-COM controls for comparison. The risks of ESRD among COM patients, with adjustment for comorbidities, namely, hypertension, diabetes, coronary artery disease, congestive heart failure, and hyperlipidemia, were assessed until the end of 2010.ESRD risk was 2.01-fold higher (95% confidence interval [CI]: 1.81-2.25) in the COM cohort than in the non-COM cohort. Regarding the joint effect of COM with comorbidity, the ESRD risk was 1.57-fold higher (95% CI: 1.23-2.00) for the COM cohort without comorbidities and increased to 2.25 (95% CI: 1.97-2.57) for the COM cohort with at least 1 comorbidity. Age-specific analysis revealed that the adjusted ESRD risk for the COM cohort increased as age decreased, with the highest hazard ratio being 17.8 (95% CI: 5.18-61.4) for patients aged 20-34 years.This was the first study to report that COM is associated with an increased risk of ESRD, particularly among patients with comorbidities and younger patients.