High frequency of ulcers, not associated with Helicobacter pylori, in the stomach in the first year after kidney transplantation

Telkes, Gabor, Peter, Antal, Tulassay, Zsoly and Asderakis, Argiris ORCID: https://orcid.org/0000-0001-6859-2020 2011. High frequency of ulcers, not associated with Helicobacter pylori, in the stomach in the first year after kidney transplantation. Nephrology Dialysis Transplantation 26 (2) , pp. 727-732. 10.1093/ndt/gfq401

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Abstract

Background. Although gastrointestinal (GI) symptoms are very frequent in organ transplant patients, there is a paucity of data about the endoscopic findings of kidney recipients. Methods. Two thousand one hundred and thirty-five kidney transplants were performed between 1994 and 2007. During that period, 672 gastroscopies were performed in 543 of those patients. Their mean age was 49.5 years and 56.9% were male. Immunosuppressive combinations included cyclosporine–mycophenolate–steroids, cyclosporine–steroids and tacrolimus–mycophenolate mofetil–steroids. Ninety-eight percent of the patients received acid suppression therapy. Results. The rate of clinically significant endoscopic findings was 84%. Macroscopic findings included inflammation in 46.7%, oesophagitis in 24.7%, ulcer in 16.9% and erosions in 14.8% of cases. Twenty-nine percent of endoscopies showed ulcer disease more frequently in the first 3 months (P = 0.0014) after transplantation than later, and 45.7% of all ulcers developed in the first year. The presence of Helicobacter pylori was verified in 20.9% of cases, less than in the general, and also in the uraemic population (P < 0.0001). There was no association between the presence of H.pylori and ulcers (P = 0.28). Steroid pulse treatment for rejection was not associated with more ulcers (P = 0.11); the use of mycophenolate mofetil increased the risk of erosions by 1.8-fold. Conclusion. More than 25% of all kidney recipients required upper endoscopy in their ‘post-transplant life’; the prevalence of ‘positive findings’ and ulcer disease was higher than in the general population (P < 0.0001). The most vulnerable period is the first 3 months. Mycophenolate mofetil had an impact on GI complications, whilst the presence of H.pylori in the transplant population is not associated with the presence of ulcers.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General)
Publisher:	Oxford University Press
ISSN:	0931-0509
Date of Acceptance:	15 June 2010
Last Modified:	28 Oct 2022 10:12
URI:	https://orca.cardiff.ac.uk/id/eprint/77102

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