P1719GASTRODUODENAL LESIONS AND HELICOBACTER PYLORI INFECTION IN ASYMPTOMATIC RENAL TRANSPLANT CANDIDATES

Abstract

Abstract Background and Aims Patients suffering from end stage renal disease usually cope with many problems due to their lengthy illness and its complications. Renal transplantation is the most effective therapeutic strategy in these patients. One of the post transplantation complications is gastrointestinal bleeding due to peptic ulcers and other upper gastrointestinal diseases which can affect the morbidity and mortality of these patients. The present research aims to shed lights on prevalence of gastrointestinal lesions and Helicobacter pylori infection using upper endoscopy in asymptomatic candidates for renal transplantation. Method The present cross-sectional research was performed on renal transplant candidates suffering chronic renal failure referred to Montaserie organ transplantation center in the time period of January 2016, to January 2018. Eighty five ESRD patients, 45 male and 40 female, mean age 39.09 ± 11.09 years, enrolled in the study. Hypertension and diabetes were the most common causes of kidney failure in the patients. In the present research about 90.6% of patients had been on chronic dialysis,. Mean duration of vintage time on dialysis was 20.46 ±16.12 months, and hemodialysis (87%) was the most common dialysis method. Including criteria were patients candidature for renal transplant and consent for involvement in the research. Excluding criteria were patients with apparent dyspeptic symptoms, patients with known upper gastrointestinal diseases, and patients who have been using PPIs (proton pump inhibitors), NSAIDs(non-steroid anti-inflammatory drug), H2 blockers or antibiotics over the past two weeks preceding the enrollment in study . Patients who met criteria underwent endoscopy and were classified according to endoscopic findings, Helicobacter pylori infection and pathologic findings. Chi-square statistics was used for evaluating the correlation between categorical endoscopic or pathologic findings with categorical demographic and dialysis characteristics parameters. The Statistical Package for the Social Sciences software (SPSS version 20.0, SPSS Inc., Chicago, IL, USA) was used for data analyses. A P <0.05 was considered significant. Results Sixty two patients (72%) had significant endoscopic findings; erosive gastroduodenitis (32.5%) was the most common findings. There was not a significant correlation between endoscopic findings and: age (p = 0.5), cause of renal failure (p-value = 0.9), dialysis type (p-value = 0.08), gender (p-value = 0.9), infection with H. Pylori (p-value = 0.2) and mean duration of vintage dialysis time (p = 0.4).All the patients with significant endoscopic findings, had also significant abnormal pathologic findings on endoscopic obtained biopsied samples. Helicobacter pylori infection was seen in, 36 patient(42%)s. Significant association between H. Pylori infection and abnormal pathology was found (p=0.04) . Conclusion Asymptomatic gastrointestinal lesions and Helicobacter pylori infection are prevalent in renal transplant candidates, so routine upper endoscopy in these patients is strongly recommended.