Influences of Helicobacter pylori on serum pepsinogen concentrations in dialysis patients

Background. Patients with impaired renal function have been known to have e levated concentrations of serum pepsinogens, which are raised by Helicobact er pylori infection of the stomach. The present study was performed to exam ine the effect of H. pylori infection on serum pepsinogen concentrations in dialysis patients. Methods. Forty nine patients on dialysis and 48 subjects with no known kidn ey disease were examined for upper gastroduodenal endoscopy, H. pylori infe ction and serum concentrations of pepsinogen I and II. The status of H. pyl ori infection was evaluated from results of a urease test, histology and cu lture of biopsy specimens of the gastric mucosa. Serum pepsinogen levels we re measured by radioimmunoassay. Results. Serum concentrations of pepsinogen I and II were elevated in the d ialysis patients in comparison with those in the controls (277.4 +/- 24.2 v s 52.6 +/- 4.0 pg/ml, P < 0.01 for pepsinogen I, and 30.2 +/- 2.9 vs 14.9 /- 1.3 pg/ml, P < 0.01 for pepsinogen II). In both the dialysis patients an d controls, those with H. pylori infection had significantly higher concent rations of serum pepsinogen I and II and a lower ratio of pepsinogen I to p epsinogen II than those without infection. Among the controls, 15 of 25 sub jects with atrophic gastritis had a pepsinogen I/pepsinogen II ratio less t han or equal to 3.0, while only two out of 17 patients on dialysis fell int o this range. Conclusions. We conclude that H. pylori status should be taken into account when serum pepsinogen concentrations are evaluated in dialysis patients.