Introduction: Chronic kidney disease (CKD) is a growing global health concern, frequently associated with gastrointestinal (GI) symptoms such as dyspepsia, which can significantly impair quality of life. Helicobacter pylori ( H. pylori ) infection, a well-known cause of gastritis and peptic ulcer disease, is hypothesized to exacerbate GI symptoms and systemic inflammation in CKD patients. This study aimed to determine the prevalence of H. pylori infection in dialysis-naïve CKD patients with upper GI symptoms and compare it with non-CKD symptomatic controls. Materials and Methods: This prospective, comparative, cross-sectional study enrolled 54 CKD Stage 3–5 patients and 53 symptomatic non-CKD controls. Recent Proton pump inhibitor (PPI) (2 weeks) and antibiotic use (4 weeks) were excluded. All participants underwent upper GI endoscopy; a single antral biopsy was obtained for rapid urease test (RUT). Multivariable logistic regression was adjusted for age and sex. Results: H. pylori infection was detected in 32/54 CKD cases (59.3%) and 23/53 controls (43.4%) ( χ 2 = 2.10, P = 0.147), indicating a nonsignificant trend toward higher prevalence among CKD patients. Antral gastritis was the most frequent endoscopic finding in CKD (68.5%). In multivariable analysis, older age ( P = 0.05), lower hemoglobin ( P = 0.02), and higher urinary albumin-creatinine ratio (UACR) ( P = 0.04) independently predicted H. pylori positivity within CKD patients. Conclusion: Although H. pylori prevalence was numerically higher in CKD patients, the difference was not statistically significant. Associations of H. pylori with age, anemia, and UACR in CKD should be interpreted as exploratory. Given the high burden of GI abnormalities in CKD, targeted evaluation remains justified, but routine screening solely based on CKD status cannot be recommended from this study.
Husain et al. (Thu,) studied this question.