Does Helicobacter pylori infection play a role in iron deficiency anemia in hemodialysis patients?

BACKGROUND: Among the disorders that may affect patients with end-stage renal disease (ESRD), anemia is the most responsive to treatment; any reversible cause should be identified, and the most common reversible cause is iron deficiency. We investigated the relationship between <italic>Helicobacter pylori</italic> infection and iron deficiency anemia in a hemodialysis population.

MATERIALS AND METHODS: This cross-sectional study included 90 adult patients with ESRD on maintenance hemodialysis. Iron deficiency anemia (IDA) was determined by hemoglobin, serum iron, ferritin, and transferrin saturation (TSAT) values. <italic>H. pylori</italic> diagnosis was done by detection of <italic>H. pylori</italic> antigen in stool.

RESULTS: It was found that <italic>H. pylori</italic> stool antigen was positive in 50 patients (55.6%), while 40 patients were negative for <italic>H. pylori</italic> (44.4%). 71% of patients had anemia (Hb < 10 g/dL), and 63% of patients had iron deficiency anemia (TSAT < 30%). No significant differences were found between <italic>H. pylori</italic> positive and -negative groups in any of the variables analyzed: hemoglobin (8.96 ± 1.8 vs.9.76 ± 1.4 g/dL), serum iron (86 ± 17.5 vs. 87 ± 18.2 pg/dL), ferritin (284.8 ± 60.5 vs. 301.4 ± 50.1 ng/dL), or TSAT index (26.79 ± 18.42% vs. 29.83 ± 18. 01% µg/dL).

CONCLUSION: <italic>H. pylori</italic> infection has a nonsignificant effect on iron deficiency anemia in hemodialysis patients. We recommend that routine screening for <italic>H. pylori</italic> is not needed among dialysis patients with iron deficiency anemia.
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