Association between duration of dialysis and Helicobacter pylori infection in dialysis patients: a meta-analysis.

Abstract

The association between Helicobacter pylori (HP) infection and duration of dialysis in dialysis patients is conflicting, this meta-analysis was conducted to elucidate the association between duration of dialysis and HP infection status in dialysis patients, and subgroup study was conducted to explore its influencing factors. Furthermore, our study aims to provide advice on the treatment of dialysis patients. Articles published up to 30 September 2018 were searched from PubMed, Embase, Sinomed, Medline, China Knowledge Resource Integrated Database (CNKI) and Wang fang database. Two researchers independently identified whether studies met the eligibility criteria. The adjusted relative risk (RR) or the weighted mean difference (WMD) and their 95% CI were estimated. I2 was performed to evaluate the statistical heterogeneity. Publication bias was evaluated using Egger's test and a funnel plot. Fourteen studies were included involving 2087 dialysis patients, 815 of them were HP positive, 1272 of them were HP negative. Quantitative data and qualitative data were analyzed, respectively. For quantitative data, statistical differences were observed in the association between HP infection and duration of dialysis (P = 0.008), also in the hemodialysis subgroup (P = 0.006). After stratifying by detection methods, differences still existed in groups with different detection methods (P = 0.001, P = 0.033). For qualitative data, there was no statistical difference in the association between HP infection rate and duration of dialysis (P = 0.295). Furthermore, we found that the age was higher in HP positive patients than in HP negative patients (P < 0.001). Our meta-analysis found that HP infection rate was negatively correlated with accumulative dialysis time, and methods of HP detection did not influence the association between HP infection and accumulative dialysis time. We also found that age was the risk factor of HP infection in dialysis patients. Further studies need to be performed to elucidate the mechanism of the correlation between HP infection and duration of dialysis, to explore which timing period of dialysis is most susceptible to HP infection, then, improve the prognosis of patients with renal diseases.