| [ Summary ] |
The prevalence of Helicobacter pylori (H.pylori) infection in dialysis patients with upper-gastro-intestinal symptoms is about 60%. The incidence of H. pylori infection in gastro-duodenal lesions (for example, various types of gastritis, gastric ulcers, duodenal ulcers), is similar in dialysis patients compared to the general population. H. pylori infection should be evaluated in dialysis patients with upper-gastrointestinal symptoms, when gastrofiberscopy is performed. The cost for eradication of H.pylori has been covered by national health insurance in Japan since Novemher 2000. Triple regimens, combining proton pump in hibitors (lansoplazole) with two antibiotics (amoxycillin, clarithromycin) are recommended to eradicate H. pylori. Many reports are available regarding eradication of H. pylori in dialysis patients, and successful eradication rates using triple regimens has been shown to reach 60 to 90% in these reports. Since H.pylori bacteria become less numerous after eradication, the urea breath test is recommended for evaluation after treatment, in order to avoid false-negative result in diagnostic procedures. However, an appropriate value for the urea breath test should be established for dialysis patients, because relatively high levels of blood urea nitrogen in dialysis patients may influence to the results of the urea breath test. |