Gastroduodenal lesions and Helicobacter pylori in children with end-stage renal disease

Thirty-seven children with end-stage renal disease were evaluated for gastr oduodenal lesions by upper gastrointestinal endoscopy between January 1993 and January 1998. The mean (+/-SD) age of the patients was 14.3+/-2.4 years (range 9-17 years). Endoscopic examination was abnormal in 17 patients (46 %). The lesions were antral gastritis plus bulbitis (n=6), nodular bulbitis (n=4), antral gastritis (n=4), and duodenal ulcer (n=3). Fifteen patients had symptoms related to gastroduodenal disease, whereas 22 patients were as ymptomatic at the time of endoscopic examination; 80% of the symptomatic an d 23% of the asymptomatic patients had gastroduodenal lesions on endoscopy. Antral mucosal biopsy was taken from 26 of 37 children for the detection o f Helicobacter pylori by the urease test. H. pylori was detected in 10 of 1 6 patients with gastroduodenal lesions (8 symptomatic, 2 asymptomatic). Non e of the patients with normal endoscopic examination were positive for H, p ylori. Thus, we have demonstrated a significant number of gastroduodenal le sions and their frequent association with H. pylori in our pediatric renal transplant candidates. Our results emphasize the importance of gastrointest inal evaluation in these patients. Endoscopic examination should be conside red in symptomatic patients and in areas where H. pylori is endemic.