To determine whether Hp is an agent responsible for Gastrointestinal problems in uremic children, and to assess fasting gastrin concentrations in children with and without renal failure in the Hp-positive and -negative groups. This case control study was conducted in 24 children on chronic hemodialysis; female/male 13/11, mean age 14.7±3.4 years, and 25 healthy age- and sex-matched children recruited at the Gastroenterology outpatient clinic as a control group, over a 12-month period. Hp infection was evaluated by using direct antral histological examination and rapid urease test. Fasting serum gastrin levels were measured in both groups. H. pylori was detected in sixteen uremic patients (66%) and in 5 children (20%) in control group (p<0.001). High serum gastrin levels in infected and non-infected uremic children were detected in 75% and 12.5%, separately (p<0.001). The same differences was seen in control group (80% vs. 15%, p<0.001). Mean fasting serum gastrin levels in infected and non-infected uremic children were equal to 208 and 97.2 ng/lit, respectively (p<0.001). There were no statistical differences between uremic and control groups regarding percentage of high serum gastrin levels in infected and non-infected cases. But, the mean fasting gastrin levels in 5 Hp-positive non-uremic children (126.6 ng/l) were significantly different from those in 16 Hp-positive uremic children (208 ng/l) (p<0.05). This difference was not seen in non-infected cases between uremic and healthy groups, (97.2 vs. 78.7ng/l, p> 0.05). In conclusion, We found Hp infection and secondary hypergastrinemia is more frequent in uremic children than normal population. Meanwhile, Hp infection in uremic children is accompanied with higher level of serum gastrin. Our results emphasize the importance of periodic, and also pre-transplant gastrointestinal evaluation in these patients to find out their problem and manage appropriately.
Volume : 6
Issue : 4
Pages : 21
Pediatric Nephrology and Gastroenterology Mashhad and Shiraz Universities of Medical Sciences.