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Abstract

The aim of this work is to study gastric symptoms, efficacy of hemodialysis according to blood urea, serum creatinine levels and urea reduction ratio (URR), changes in mental functions according to serum ammonia level in hemodialysis patients with positive H. pylori antigen before and after eradication therapy. This study was carried out on 40 patients with end stage renal disease (ESRD) on chronic regular hemodialysis 3 times weekly, with gastric symptoms and positive stool H. pylori antigen were enrolled in this study. Blood urea, serum creatinine, urea reduction ratio, serum ammonia all were measured before and after eradication therapy. Stool H. pylori antigen was measured by ELISA before and one month after the end of therapy to confirm complete eradication of the organism. Eradication therapy was given (Amoxycillin 750 mg two times daily, Clarithromycin 500 mg two times daily and Pantazole 20 mg two times daily) for 10 days. Then after one month changes in gastric symptoms, stool H. pylori antigen, measure serum ammonia level again, H. pylori antigen, blood urea and serum creatinine were detect. The results of this study: gastrointestinal tract (GIT) symptoms pre-eradication therapy were 25% nausea, 21.5% epigastric pain, 16.1% heart burn, 12.5% early satiety, 12.5% postprandial fullness, 12.5% appetite loss. One month after eradication therapy 85% of the patients converted to H. pylori stool antigen negative. After eradication therapy, patients who converted to H. pylori negative antigen (GIT) symptoms had been relieved in 82.4% of cases and in 17.6%of cases (GIT) symptoms persist. There was significant difference in the mean blood ammonia level (p=0.001) as regards pre and post eradication therapy. In patients who still had H. pylori antigen (GIT) symptoms had been persisted in all cases and there was no significant difference in the mean blood ammonia level (p=0.463). There was significant negative correlation between H. pylori antigen with urea reduction ratio (URR) (r=0.402, p=0.010) and significant positive correlation between H. pylori antigen with ammonia level (r=0.452, p=0.003). This study showed that the prevalence of H. pylori infection increased with longer duration of hemodialysis, triple therapy was effective for eradication of H. pylori in hemodialysis patients, presence of H. pylori was associated with decreased efficacy of hemodialysis and blood ammonia level decreased with eradication of H. pylori infection.

Biography

Nany El Gayar pursued her Master’s Degree in Rheumatology and Doctor’s Degree in Geriatrics from Alexandria University. She is an Assistant Professor of Internal Medicine, Geriatrics Unit at the Alexandria University, Egypt. She has published more than 15 papers in reputed journals.

E-mail: dr_nany_hasan@yahoo.com