Published online Apr 21, 2018. doi: 10.3748/wjg.v24.i15.1591
Peer-review started: February 23, 2018
First decision: March 15, 2018
Revised: March 18, 2018
Accepted: March 25, 2018
Article in press: March 25, 2018
Published online: April 21, 2018
Core tip: Hemodialysis (HD) patients have a poor prognosis related in part to protein-energy wasting (PEW), associated with low levels of ghrelin. The severity of gastric mucosal atrophy has been suggested as the major determinant of ghrelin levels. Eradication of Helicobacter pylori (H. pylori) improves nutritional status, with serum cholinesterase and cholesterol levels stimulated by rising ghrelin levels and appetite, especially in H. pylori infection-positive patients with severe gastric mucosal atrophy. Although infection rates of H. pylori have been decreasing in HD patients, it would be preferable to eradicate H. pylori promptly before progression of gastric atrophy for prevention of gastric cancer and PEW.