Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1497
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
To investigate the prevalence and association of Helicobacter pylori (H. pylori) with end-stage renal disease (ESRD).
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.
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).
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.
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.