Helicobacter pylori-specific IgG in chronic haemodialysis patients: relationship of hypergastrinaemia to positive serology.

BACKGROUND: Chronic haemodialysis (HD) patients frequently suffer from dyspeptic symptoms and hypergastrinaemia is a common finding in these patients. Helicobacter pylori (H. pylori) infection is associated with dyspepsia and hypergastrinaemia. METHODS: The aim of this study was to determine whether H. pylori is frequently found in HD patients and to explore the relationship of H. pylori with dyspeptic symptoms and/or hypergastrinaemia in these patients. Serum H. pylori specific IgG were measured by an in-house enzyme-linked immunosorbent assay (sensitivity and specificity is 97% and 91% respectively) in 103 chronic HD patients. The patients (53 M, 50 F, mean age f60 +/- 13 years) completed a questionnaire exploring the type, frequency and intensity of dyspeptic symptoms. Fasting plasma gastrin levels were also measured. Serum and plasma samples from 103 hospital patients matched for age, sex and dyspepsia were use as controls. RESULTS: There was no significant difference in terms of serum H. pylori IgG between HD patients and controls (0.977 +/- 0.295 vs 1.046 +/- 0.306 OD respectively). The prevalence of subjects with positive serology was relatively high in both groups, but did not differ between HD patients (73%) and controls (78%). Dyspepsia was reported in 72 (70%) cases. There was no relationship between presence (and grading) of dyspepsia or type of dyspeptic symptoms and H. pylori serology. In the HD group, patients seropositive for H pylori had a significantly higher gastrinaemia than those who were seronegative: 598 +/- 413 ng/ml vs 309 +/- 252 ng/ml (P < 0.0001). The relationship between seropositivity for H. pylori and hypergastrinaemia was significant (P = 0.00038), after adjustment by multiple regression analysis for sex, age, smoking, alcohol, months on dialysis, renal function, drugs, and dyspepsia. CONCLUSIONS: Data of this study suggest that H. pylori may play a role in contributing to hypergastrinaemia of HD patients.

The new AN69 membrane in biofiltration (BF): 18 month's follow-up.

BF is a dialytic procedure employing the new AN69 polyacrylonitrile membrane, which is more permeable to both water and solutes than the traditional AN69. A postdilutional bicarbonate infusion is necessary in BF. The treatment time is 3 hours. Six patients, previously on regular acetate (HD) or bicarbonate dialysis (BHD) with AN69 were treated for 18 months with BF. Biochemical and hematological parameters (BUN, creatinine, uric acid, CA, P, K, Na, blood pH, HCO3, hematocrit) and clinical signs were evaluated in BF, and compared to those of HD and BHD. An improvement in biochemical and hematological parameters accompanied by better clinical signs was seen in BF as compared to HD and BHD. In our opinion this is due both to better removal of small and middle molecules and the bicarbonate infusion, and to the shorter dialytic session.