الفهرس 
Aim of workOnly 14 pages are availabe for public view
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Abstract
H. pylori is a Gram‐negative micro‐aerophilic bacterium that colonizes the human gastric mucosa. H. pylori infection is one of the most common bacterial infections worldwide and its prevalence has been estimated to extend from 40 to 80% and it changes widely by geographic region, age, race, ethnicity, and socioeconomic factors.
Along with decreased GI motility caused by diabetes mellitus, uremia, intestinal ischemia brought on by circulatory failure, adverse drug reactions, amyloid protein deposition, and reduced GI motility, H. pylori infection is thought to be one of the main risk factors for GI problems in dialysis patients. For detecting H. pylori infections prior to ET and gauging the effectiveness of ET in patients with end-stage renal disease (ESRD), the H. pylori Stool Antigen (HpSA) is a noninvasive and trustworthy technique.
As anticoagulant or antiplatelet medications are frequently prescribed to HD patients, bleeding from gastroduodenal ulcers may be lethal. Therefore, eliminating H. Pylori is thought to be crucial for people receiving HD.
The aim and patients:
The aim of study is to determine the HD efficacy in HD patients with H. pylori infection before and after eradication by four regimens of treatment.
To elucidate this aim 80 patients with end stage renal disease undergoing maintenance HD treatment. Patients were classified in to four groups:
● group I: including 20 Hemodialysis patients under triple therapy (LCA) (lansoprazole 30 mg b.i.d, clarithromycin 500 mg b.i.d, amoxicillin 1 g b.i.d for 2 weeks).
● group II: including 20 Hemodialysis patients under triple therapy (LCM) (lansoprazole 30 mg b.i.d, clarithromycin 500 mg b.i.d, metronidazole 500 mg b.i.d for 2 weeks).
● group III: including 20 Hemodialysis patients under quadruple therapy (LCAM) (lansoprazole 30 mg b.i.d, clarithromycin 500 mg b.i.d, amoxicillin 1g b.i.d, metronidazole 500 mg b.i.d for 2 weeks).
● group IV: including 20 Hemodialysis patients under sequential treatment (Sequential) (lansoprazole 30 mg b.i.d for two weeks; first week: amoxicillin 1g b.i.d and second week: clarithromycin 500 mg b.i.d, metronidazole 500 mg- b.i.d).
Summary of results:
In the present study the mean total age in the studied groups was 51.12 ± 14.87 years, there were 46 (57.5%) males and 34 (42.5%) females, the duration of dialysis ranged from 6 months to 9 years, with a mean of 5.63 ± 2.93. The cause of renal failure was diabetic nephropathy in 17.5% of the studied patients and hypertension in 18.7%. Arteriovenous fistula was used as an access for HD in 95% and dialysis catheter in 5%.
The most common GI symptoms were epigastric pain, nausea and heartburn. After treatment there were 59 (73.75%) of the total studied cases were negative of H pylori antigen in stool and only 21 (26.25%) were positive of H pylori antigen in stool.
There was a statistically significant difference in between before and after treatment as regard to hemoglobin in group III and group IV.
There was a statistically significant difference in between before and after treatment as regard to white blood cells in group III and group IV.
The mean platelet volume showed a statistically significant difference before and after treatment in group III and group IV.
As regard to urea and creatinine level, the mean urea and creatinine level showed non statistically significant difference before and after treatment in all groups.
The mean URR in the studied patients before ET was 65.13± 2.46and after 68.05± 2.16 ET it was. There was a significant difference in URR between the patients before and after the ET (P value = 0.046).
The mean Kt/V in the studied patients before ET was 1.32± 0.08 and after ET it was 1.50± 0.08. There was a significant difference in Kt/V between the patients before and after the ET (P value = 0.004).
There was a statistically significant positive relation in between H. pylori eradication and Efficacy of HD with P=0.002, 0.003 respectively.