Meta-Analysis
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1497-1506
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1497
Association between Helicobacter pylori and end-stage renal disease: A meta-analysis
Karn Wijarnpreecha, Charat Thongprayoon, Pitchaphon Nissaisorakarn, Natasorn Lekuthai, Veeravich Jaruvongvanich, Kiran Nakkala, Ridhmi Rajapakse, Wisit Cheungpasitporn
Karn Wijarnpreecha, Charat Thongprayoon, Ridhmi Rajapakse, Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, United States
Pitchaphon Nissaisorakarn, Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, United States
Natasorn Lekuthai, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Veeravich Jaruvongvanich, Department of Medicine, University of Hawaii, Honolulu, HI 96822, United States
Kiran Nakkala, Cape Fear Center for Digestive Diseases, P.A., Fayetteville, NC 28312, United States
Wisit Cheungpasitporn, Division of Nephrology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Cheungpasitporn W contributed to conception and design of the study, and critical revision; Wijarnpreecha K, Thongprayoon C, Nissaisorakarn P and Jaruvongvanich V contributed to acquisition of data, Wijarnpreecha K, Nissaisorakarn P, Lekuthai N, Jaruvongvanich V, Nakkala K and Rajapakse R interpreted the data; Wijarnpreecha K and Thongprayoon C drafted the article; Lekuthai N, Nakkala K and Rajapakse R revised the article; all authors approved the final version.
Conflict-of-interest statement: The authors deny any conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wisit Cheungpasitporn, MD, Division of Nephrology, Department of Internal Medicine, Mayo Clinic, 200 First street SW, Rochester, MN 55905, United States. wcheungpasitporn@gmail.com
Telephone: +1-507-2848450 Fax: +1-507-2667891
Received: October 30, 2016
Peer-review started: November 6, 2016
First decision: December 2, 2016
Revised: December 9, 2016
Accepted: January 18, 2017
Article in press: January 18, 2017
Published online: February 28, 2017
Processing time: 119 Days and 5.1 Hours
Abstract
AIM

To investigate the prevalence and association of Helicobacter pylori (H. pylori) with end-stage renal disease (ESRD).

METHODS

SA comprehensive literature search was completed from inception until October 2016. Studies that reported prevalence, relative risks, odd ratios, hazard ratios or standardized incidence ratio of H. pylori among ESRD patients were included. Participants without H. pylori were used as comparators to assess the association between H. pylori infection and ESRD. Pooled risk ratios and 95%CI was calculated using a random-effect model. Adjusted point estimates from each study were combined by the generic inverse variance method of DerSimonian and Laird.

RESULTS

Of 4546 relevant studies, thirty-seven observational studies met all inclusion criteria. Thirty-five cross-sectional studies were included in the analyses to assess the prevalence and association of H. pylori with ESRD. The estimated prevalence of H. pylori among ESRD patients was 44% (95%CI: 40%-49%). The pooled RR of H. pylori in patients with ESRD was 0.77 (95%CI: 0.59-1.00) when compared with the patients without ESRD. Subgroup analysis showed significantly reduced risk of H. pylori in adult ESRD patients with pooled RR of 0.71 (95%CI: 0.55-0.94). The data on the risk of ESRD in patients with H. pylori were limited. Two cohort studies were included to assess the risk of ESRD in patients with H. pylori. The pooled risk RR of ESRD in patients with H. pylori was 0.61 (95%CI: 0.03-12.20).

CONCLUSION

The estimated prevalence of H. pylori in ESRD patients is 44%. Our meta-analysis demonstrates a decreased risk of H. pylori in adult ESRD patients.

Keywords: Helicobacter pylori; Kidney failure; Renal disease; Renal insufficiency; End stage kidney disease; Meta-analysis

Core tip:Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in gastrointestinal tract of humans. The prevalence and association of H. pylori with end-stage renal disease (ESRD), however, are still unclear. To further investigate this potential relationship, we conducted this systematic review and meta-analysis of observational studies reporting the association between H. pylori infection and ESRD and prevalence in ESRD patients. We found an estimated prevalence of H. pylori in ESRD patients of 44%. In addition, our meta-analysis demonstrates a 0.71-fold decreased risk of H. pylori in adult ESRD patients.