The Japanese Journal of Clinical Dialysis Vol.22 No.8(11)

Theme Diseases of Alimentary Tract in Maintenance Dialysis Patients
Title Eradication of Helicobacter pylori (Hp) in patients undergoing hemodialysis
Publish Date 2006/07
Author Kazuro Itoh Second Department of Internal Medicine, National Defense Medical College
[ Summary ] For hemodialysis patients with bleeding tendencies and / or anemia, non-invasive methods, such as urea breath test and the Helicobacter pylori (Hp) stool antigen test, are preferable for the diagnosis of HP infection. Although the precise mechanism is unknown, the prevalence of Hp infection in hemodialysis patients is rather low even in the elderly. Hp infection is infrequent, especially in dialysis patients suffering from hemorrhagic mucosal lesions of the stomach, which is the major complication observed in these patients. However, the prevalence of Hp infection in dialysis patients with gastric or duodenal ulcers is as high as in the corresponding non-dialysis patient group, and the eradication of Hp is indicated for these patients. Therapy with conventional anti-Hp drugs has been hampered due to insufficient renal clearance. The prefered medication and antibiotic therapy dosage for these patients has not been established. We have successfully treated these patients using a combination of lower dosages of LPZ (60 mg / day), AMPC (500 mg / day) and CAM (200 mg / day), achieving high eradication rates of over 90 %.
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