Risk of Chronic Kidney Disease after Early and Late Helicobacter pylori Eradication in Patients with Peptic Ulcer Disease: A Population-Based Cohort Study in Taiwan

摘要

Background: Helicobacter pylori play a central role in the development of chronic gastritis, gastric and duodenalulcers, and gastric cancer. The risk of upper gastrointestinal bleeding in patients with chronic kidney disease (CKD)or end stage renal disease is reportedly higher than that in the general population. The effects of early and late H.pylori eradication on kidney disease rates warrant further investigation.Methods: We conducted a population-based study by using Taiwan’s National Health Insurance ResearchDatabase of 1 million beneficiaries. The enrolled-date of this database is from January 1, 2000 to December 31,2009. We compared the incidence and risk of CKD in 3,689 patients in the early H. pylori eradication cohort withthose in 4,298 patients in the late H. pylori eradication cohort.Results: The adjusted hazard ratio (HR; 95% confidence interval (CI)=1.17–1.77) for subsequent CKD was 1.44-fold higher in the late eradication cohort than in the early eradication cohort. In subgroup analysis, in patients aged40–65 years, the HR was 1.55 (95% CI=1.14–2.10) and in those aged >65 years, the HR was 1.41 (95% CI=1.03–1.93).Conclusion: This nationwide population-based cohort study provides evidence that patients with late eradicationof H. pylori are at higher risk of CKD than those with early eradication of H. pylori.