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 Helicobacter pylori 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. H. pylori diagnosis was done by detection of H. pylori antigen in stool. RESULTS: It was found that H. pylori stool antigen was positive in 50 patients (55.6%), while 40 patients were negative for H. pylori (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 H. pylori 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: H. pylori infection has a nonsignificant effect on iron deficiency anemia in hemodialysis patients. We recommend that routine screening for H. pylori is not needed among dialysis patients with iron deficiency anemia.
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