Hemodialysis patients have lower prevalence of Helicobacter pylori infection: a case–control study

Abstract Background Whether the prevalence of Helicobacter pylori ( H. pylori ) infection is lower in hemodialysis patients than that in patients with normal renal function remains controversial. We performed multivariable logistic regression analysis in hemodialysis patients and patients with normal renal function to compare the prevalence of H. pylori infection in these patients. We also investigated the relationship between the prevalence of H. pylori infection and the duration of hemodialysis. Methods This retrospective study population included hemodialysis patients who received regular hemodialysis in four hospitals and had their anti- H. pylori antibodies measured between January 2014 and February 2021, as well as consenting patients who had their anti- H. pylori antibodies measured between May and June 2021. Subjects with normal renal function who underwent a medical check-up at two hospitals and had their anti- H. pylori antibodies measured between January 2014 and February 2021 were selected to match the hemodialysis patients for age, sex, and time of diagnosis of H. pylori infection. These subjects formed the control group. Results A total of 218 patients were enrolled in the study, with 109 in the hemodialysis group and 109 in the control group. The prevalence of H. pylori infection in the hemodialysis and control groups was 12.8% (95% confidence interval [CI] 7.2%, 20.6%) and 41.3% (95% CI 31.9%, 51.1%), respectively. To adjust for confounding, the model included body mass index (BMI), smoking status, alcohol consumption, age, sex, and use of gastric medications as covariates. A significant association was observed between the prevalence of H. pylori infection and hemodialysis (odds ratio [OR], 0.32; 95% CI 0.1, 0.97; p = 0.045). In the hemodialysis group, the association between the duration of hemodialysis and the prevalence of H. pylori infection was not clear (OR, 0.98; 95% CI 0.91, 1.06; p = 0.607). Conclusions The prevalence of H. pylori infection in hemodialysis patients was significantly lower than that observed in patients with normal renal function.