Evaluation of noninvasive tests for diagnosis of Helicobacter pylori infection in hemodialysis patients.

BACKGROUND Hemodialysis is the most common method of renal replacement therapy for treatment of acute and chronic kidney failure. Helicobacter pylori (H. pylori) plays a major role in development of peptic ulcer, gastric neoplasms, and lymphoma as well as increased risk of cardiovascular disorders in hemodialysis patients. OBJECTIVES In this study the diagnostic values of noninvasive tests [i.e. urea breath test (UBT), helicobacter pylori stool antigen test (HPSA) and serology] in diagnosis of H. pylori infection in hemodialysis patients have been studied. PATIENTS AND METHODS All patients undergoing hemodialysis in Fatemieh Hospital, Semnan, Iran, were enrolled in the study, and their H. pylori status were assessed by using non-invasive tests including UBT, HPSA and serology. Patients with at least two out of 3 positive tests were considered infected with H. pylori. RESULTS The sensitivity, specificity, and positive and negative predictive values of the tests used in diagnosing H. pylori infection were 62.5%, 65.4%, 62.5% and 65.4% for UBT, 100%, 72.2%, 58.3% and 100% for serology, and 100%, 75%, 60.9% and 100% for fecal antigen test, respectively. CONCLUSIONS This study showed that H. pylori serology and stool antigen tests have higher diagnostic values than UBT, and they are more reliable than UBT in diagnosis of H. pylori infection in hemodialysis patients.