Advantage of eradication therapy for Helicobacter pylori before kidney transplantation in uremic patients.

ABSTRACTFrom January 1999 to February 2007, 61 end-stage renal disease (ESRD) candidatesfor kidney transplantation underwent an esophagogastroduodenoscopy (EGDS) todetect Helicobacter pylori (HP). We correlated treatment for HP before transplantationand upper digestive tract hemorrhagic complications and possible recurrence of pepticdisease posttransplantation. The 32 (52.4%) HP-Positive cases were divided into 2groups: (1) 17 patients who underwent treatment for the eradication of the infectionwith 40 mg/d omeprazole for 4 weeks, 500 mg claritromycin twice daily for 7 days, and2 g/d amoxicillin for 7 days; and (2) 15 untreated patients. No significant differenceswere found in the hemorrhagic erosive gastritis of patients with regard to the treatedHP-Positive and nontreated HP-Positive patients (2 vs 3) and between the HP-negativepatients and the nontreated HP-Positive patients (2 vs 3). The presence of gastric orduodenal ulcers was significantly higher in the nontreated patient than in the treatedHP-positive patients (5 vs 1; P .05) and significantly higher in the nontreatedHP-Positive patients than in the HP-negative patients (5 vs 0; P .05). We concludedthat HP-positive patients should therefore be treated for the infection to avoid along-term significant increase of gastric and/or duodenal peptic disease subsequent torenal transplantation in these immunodepressed subjects.