The diagnosis of Helicobacter pylori infection in uremic patients

Peter A. Rowe, Adil M. El Nujumi, Craig Williams, Stephen Dahill, J. Douglas Briggs, Kenneth E.L McColl

Research output: Contribution to journalArticle

Abstract

Two urease-based tests--the urease slide test and the radiolabeled urea breath test, are commonly used for the diagnosis of Helicobacter pylori infection of the stomach. The reliability of these tests in chronic uremia was compared with serological tests for H pylori antibodies, and with direct detection of the organism by microscopy or culture of gastric antral biopsies. Twenty-seven patients with chronic renal failure and dyspepsia underwent upper gastrointestinal endoscopy. Twelve of these patients (46%) were judged to be infected with H pylori on the basis of identification of the organism on microscopy or culture of antral biopsy. Both urease-based tests were able to determine H pylori status, despite the markedly increased concentrations of urea in the gastric juice found in chronic renal failure. The urease slide test performed on antral biopsies obtained at endoscopy proved reliable in determining H pylori status with no false-positive nor false-negative results after 20 minutes and 24 hours of incubation. The 14C-urea breath test also differentiated the infected from the uninfected patients. The 20-minute 14CO2 excretion (kg %dose/mmol CO2 x 100) ranged from 50 to 834 in the H pylori-infected patients, compared with 0.3 to 27 in the H pylori-noninfected patients (P < 0.0001); the 90-minute values ranged from 88 to 398 in the former, compared with 1 to 79 in the latter (P < 0.0001). The excretion of 14CO2 (derived from bacterial hydrolysis of ingested 14C-urea) was higher in all the uremic patients compared with nonuremic controls, and in half of the H pylori-noninfected uremic patients there was a late increase in 14CO2 excretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish
Pages (from-to)574-9
Number of pages6
JournalAmerican Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Volume20
Issue number6
DOIs
Publication statusPublished - Dec 1992
Externally publishedYes

Fingerprint

Pylorus
Helicobacter Infections
Helicobacter pylori
Urease
Urea
Breath Tests
Biopsy
Chronic Kidney Failure
Microscopy
Stomach
Gastric Juice
Gastrointestinal Endoscopy
Dyspepsia
Uremia
Serologic Tests
Endoscopy
Hydrolysis
Antibodies
Antral

Keywords

  • Adult
  • Aged
  • Breath Tests
  • Carbon Dioxide
  • Colony Count, Microbial
  • Dentition
  • Female
  • Gastric Juice
  • Gastric Mucosa
  • Helicobacter Infections
  • Helicobacter pylori
  • Humans
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Prospective Studies
  • Stomach Diseases
  • Urea
  • Urease
  • Uremia
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Rowe, Peter A. ; El Nujumi, Adil M. ; Williams, Craig ; Dahill, Stephen ; Briggs, J. Douglas ; McColl, Kenneth E.L. / The diagnosis of Helicobacter pylori infection in uremic patients. In: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation. 1992 ; Vol. 20, No. 6. pp. 574-9.
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abstract = "Two urease-based tests--the urease slide test and the radiolabeled urea breath test, are commonly used for the diagnosis of Helicobacter pylori infection of the stomach. The reliability of these tests in chronic uremia was compared with serological tests for H pylori antibodies, and with direct detection of the organism by microscopy or culture of gastric antral biopsies. Twenty-seven patients with chronic renal failure and dyspepsia underwent upper gastrointestinal endoscopy. Twelve of these patients (46{\%}) were judged to be infected with H pylori on the basis of identification of the organism on microscopy or culture of antral biopsy. Both urease-based tests were able to determine H pylori status, despite the markedly increased concentrations of urea in the gastric juice found in chronic renal failure. The urease slide test performed on antral biopsies obtained at endoscopy proved reliable in determining H pylori status with no false-positive nor false-negative results after 20 minutes and 24 hours of incubation. The 14C-urea breath test also differentiated the infected from the uninfected patients. The 20-minute 14CO2 excretion (kg {\%}dose/mmol CO2 x 100) ranged from 50 to 834 in the H pylori-infected patients, compared with 0.3 to 27 in the H pylori-noninfected patients (P < 0.0001); the 90-minute values ranged from 88 to 398 in the former, compared with 1 to 79 in the latter (P < 0.0001). The excretion of 14CO2 (derived from bacterial hydrolysis of ingested 14C-urea) was higher in all the uremic patients compared with nonuremic controls, and in half of the H pylori-noninfected uremic patients there was a late increase in 14CO2 excretion.(ABSTRACT TRUNCATED AT 250 WORDS)",
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The diagnosis of Helicobacter pylori infection in uremic patients. / Rowe, Peter A.; El Nujumi, Adil M.; Williams, Craig; Dahill, Stephen; Briggs, J. Douglas; McColl, Kenneth E.L.

In: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation, Vol. 20, No. 6, 12.1992, p. 574-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The diagnosis of Helicobacter pylori infection in uremic patients

AU - Rowe, Peter A.

AU - El Nujumi, Adil M.

AU - Williams, Craig

AU - Dahill, Stephen

AU - Briggs, J. Douglas

AU - McColl, Kenneth E.L

PY - 1992/12

Y1 - 1992/12

N2 - Two urease-based tests--the urease slide test and the radiolabeled urea breath test, are commonly used for the diagnosis of Helicobacter pylori infection of the stomach. The reliability of these tests in chronic uremia was compared with serological tests for H pylori antibodies, and with direct detection of the organism by microscopy or culture of gastric antral biopsies. Twenty-seven patients with chronic renal failure and dyspepsia underwent upper gastrointestinal endoscopy. Twelve of these patients (46%) were judged to be infected with H pylori on the basis of identification of the organism on microscopy or culture of antral biopsy. Both urease-based tests were able to determine H pylori status, despite the markedly increased concentrations of urea in the gastric juice found in chronic renal failure. The urease slide test performed on antral biopsies obtained at endoscopy proved reliable in determining H pylori status with no false-positive nor false-negative results after 20 minutes and 24 hours of incubation. The 14C-urea breath test also differentiated the infected from the uninfected patients. The 20-minute 14CO2 excretion (kg %dose/mmol CO2 x 100) ranged from 50 to 834 in the H pylori-infected patients, compared with 0.3 to 27 in the H pylori-noninfected patients (P < 0.0001); the 90-minute values ranged from 88 to 398 in the former, compared with 1 to 79 in the latter (P < 0.0001). The excretion of 14CO2 (derived from bacterial hydrolysis of ingested 14C-urea) was higher in all the uremic patients compared with nonuremic controls, and in half of the H pylori-noninfected uremic patients there was a late increase in 14CO2 excretion.(ABSTRACT TRUNCATED AT 250 WORDS)

AB - Two urease-based tests--the urease slide test and the radiolabeled urea breath test, are commonly used for the diagnosis of Helicobacter pylori infection of the stomach. The reliability of these tests in chronic uremia was compared with serological tests for H pylori antibodies, and with direct detection of the organism by microscopy or culture of gastric antral biopsies. Twenty-seven patients with chronic renal failure and dyspepsia underwent upper gastrointestinal endoscopy. Twelve of these patients (46%) were judged to be infected with H pylori on the basis of identification of the organism on microscopy or culture of antral biopsy. Both urease-based tests were able to determine H pylori status, despite the markedly increased concentrations of urea in the gastric juice found in chronic renal failure. The urease slide test performed on antral biopsies obtained at endoscopy proved reliable in determining H pylori status with no false-positive nor false-negative results after 20 minutes and 24 hours of incubation. The 14C-urea breath test also differentiated the infected from the uninfected patients. The 20-minute 14CO2 excretion (kg %dose/mmol CO2 x 100) ranged from 50 to 834 in the H pylori-infected patients, compared with 0.3 to 27 in the H pylori-noninfected patients (P < 0.0001); the 90-minute values ranged from 88 to 398 in the former, compared with 1 to 79 in the latter (P < 0.0001). The excretion of 14CO2 (derived from bacterial hydrolysis of ingested 14C-urea) was higher in all the uremic patients compared with nonuremic controls, and in half of the H pylori-noninfected uremic patients there was a late increase in 14CO2 excretion.(ABSTRACT TRUNCATED AT 250 WORDS)

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KW - Aged

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KW - Female

KW - Gastric Juice

KW - Gastric Mucosa

KW - Helicobacter Infections

KW - Helicobacter pylori

KW - Humans

KW - Kidney Failure, Chronic

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Stomach Diseases

KW - Urea

KW - Urease

KW - Uremia

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

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DO - 10.1016/S0272-6386(12)70221-4

M3 - Article

VL - 20

SP - 574

EP - 579

JO - American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation

JF - American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation

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