Association between Helicobacter pylori and end-stage renal disease: A meta-analysis

Table 1 Main characteristics of the cross-sectional studies included in this meta-analysis

Study	Country	Year	Study sample	H. pylori testing	H. pylori prevalence (%)	OR	Study quality
Offerhaus et al[36]	The Netherland	1989	Dialysis	Antibody	22/50 (44%)	0.96 (0.42-2.22)	S 3
							C 0
							O 2
Shousha et al[55]	United Kingdom	1990	Dialysis	Histology	12/50 (24%)	0.43 (0.20-0.90)	S 3
							C 0
							O 2
Loffeld et al[34]	The Netherland	1991	HD	Antibody	13/30 (43%)	1.24 (0.58-2.64)	S 3
							C 1
							O 2
Davenport et al[22]	United Kingdom	1991	HD	Antibody	27/76 (36%)	1.29 (0.75-2.22)	S 3
							C 1
							O 2
Ala-Kaila et al[16]	Finland	1991	HD	Histology	3/23 (13%)	0.68 (0.17-2.64)	S 3
							C 0
							O 2
Gladziwa et al[27]	Germany	1993	HD	Cumulative evaluation (urease, test, histology, culture and direct examiniation)	12/35 (34%)	0.44 (0.19 -1.00)	S 3
							C 0
							O 2
Giachino et al[25]	Italy	1994	HD	Urease test, histology and culture	13/40 (32%)	0.51 (0.20-1.28)	S 3
							C 0
							O 2
De Vecchi et al[51]	Italy	1995	HD and PD	Antibody	HD and PD	HD and PD	S 3
					37/67 (55%)	0.39 (0.18-0.81)	C 1
					HD	HD	O 2
					17/29 (59%)	0.54 (0.18-1.62)
					PD	PD
					20/38 (53%)	0.30 (0.11-0.81)
Jaspersen et al[31]	Germany	1995	HD	Urease test and histology	7/34 (21%)	0.44 (0.18-1.09)	S 3
							C 0
							O 2
Seyrek et al[39]	Turkey	1996	HD	Antibody	13/91 (14%)	0.56 (0.21-1.50)	S 3
							C 1
							O 2
Krawczyk et al[33]	Poland	1996	HD	Urease test and histology	13/21 (62%)	0.93 (0.27-3.20)	S 3
							C 1
							O 2
Ozgür et al[38]	Turkey	1997	HD	Urease test	28/47 (60%)	0.83 (0.41-1.69)	S 3
							C 0
							O 2
Hruby et al[30]	Poland	1997	HD	Antibody, culture	9/26 (35%) by culture	0.68 (0.19-2.44) by culture	S 3
					16/26 (62%) by antibody	0.53 (0.13-2.12)	C 0
							O 2
Yildiz et al[42]	Turkey	1999	HD	Antibody	31/47 (66%)	0.79 (0.34-1.84)	S 3
							C 0
							O 2
Fabrizi et al[23]	United States	1999	HD	Antibody	127/228 (56%)	1.11 (0.74-1.66)	S 3
							C 1
							O 2
Tamura et al[40]	Japan	1999	HD and PD	Urease test, histology, and culture	25/49 (51%)	0.88 (0.40-1.96)	S 3
							C 0
							O 2
Gür et al[28]	Turkey	1999	HD	Urease test and histology	25/45 (56%)	1.04 (0.45-2.40)	S 3
							C 0
							O 2
Araki et al[50]	Japan	1999	HD and PD	Histology and culture	29/63 (46%)	0.45 (0.22-0.91)	S 3
							C 1
							O 2
Karari et al[32]	Kenya	2000	CRF	Urease test and histology	41/77 (53%)	0.90 (0.48-1.70)	S 3
			(HD - 36%)				C 1
							O 2
Nakajima et al[53]	Japan	2002	HD	Urease test, histology, and culture	14/51 (28%)	0.30 (0.11-0.81)	S 3
							C 0
							O 2
Tsukada et al[41]	Japan	2003	HD	Histology	9/36 (25%)	0.28 (0.02-3.82)	S 3
							C 2
							O 2
Olmos et al[37]	Argentina	2003	HD	Antibody	44/93 (47%)	0.62 (0.35-1.11)	S 3
							C 2
							O 2
Nakajima et al[54]	Japan	2004	HD	Antibody	51/138 (37%)	0.35 (0.22-0.58)	S 3
							C 1
							O 2
Nardone et al[35]	Italy	2005	HD	Urease test, histology, urea breath test and stool antigen	7/11 (64%)	3.04 (0.82-11.13)	S 3
							C 0
							O 2
Blusiewicz et al[19]	Poland	2005	HD	Urease, histology	19/30 (63%)	0.71 (0.24-2.07)	S 3
							C 0
							O 2
Khedmat et al[13]	Iran	2007	HD	Urease test	46/73 (63%)	3.20 (1.88-5.44)	S 3
							C 0
							O 2
Khazaei et al[52]	Iran	2008	HD - children	Urease test, and histology	16/24 (67%)	8.00 (2.19-29.25)	S 3
							C 0
							O 2
Gioè et al[26]	Italy	2008	HD	Urease test, and histology	75/142 (53%)	1.39 (0.86-2.23)	S 3
							C 0
							O 2
Abdulrahman et al[49]	Saudi Arabia	2008	ESRD	Histology	16/40 (40%)	0.22 (0.09-0.56)	S 3
							C 1
							O 2
Asl et al[12]	Iran	2009	HD	Histology	23/40 (58%)	2.81 (1.13-6.99)	S 3
							C 1
							O 2
Sugimoto et al[56]	Japan	2009	HD	Antibody	262/539 (49%)	0.26 (0.19-0.35)	S 3
							C 0
							O 2
Chang et al[21]	South Korea	2010	HD	Urease test and histology	12/33 (36%)	0.30 (0.12-0.74)	S 3
							C 0
							O 2
Hooman et al[29]	Iran	2011	HD - children	Histology	19/68 (28%)	1.59 (0.65-3.92)	S 3
							C 0
							O 2
Genç et al[24]	Turkey	2013	HD and PD - children	Antibody	17/33 (52%)	0.69 (0.26-1.83)	S 3
							C 1
							O 2
Chang et al[20]	Taiwan	2014	ESRD	Urease test and histology	81/144 (56%)	0.54 (0.38-0.77)	S 4
							C 2
							O 3

H. pylori: Helicobacter pylori; HD: Hemodialysis; PD: Peritoneal dialysis.

Table 2 Main characteristics of the cohort studies included in this meta-analysis

Study	Lo et al[48]	Lin et al[14]
Country	Hong Kong	Taiwan
Study design	Cohort study	Cohort study
Year	2004	2015
Study sample	Type 2 diabetic patients with clinical proteinuria and renal insufficiency	H. pylori-infected and non-infected patients without ESRD
H. pylori testing	Antibody	Diagnosis of H. pylori infection (ICD-9 041.86) was used from inpatient database of The Taiwan National Health Insurance Research Database
	Positive H. pylori (Titer > 1.1 U/mL)
ESRD definition	Doubling of baseline serum creatinine concentration or need for dialysis or serum creatinine ≥ 500 μmol/L	ESRD was identified from Registry for Catastrophic Illness Patient Database
Adjusted HR	0.12 (0.03, 0.52)	2.58 (2.33, 2.86)
Confounder adjustment	Sex, H. pylori status, serum creatinine, hemoglobin, systolic blood pressure, ACE inhibitors, Hepatitis B surface antigen status	Age, sex, comorbidity
Quality assessment (Newcastle-Ottawa scale)	Selection: 3	Selection: 4
	Comparability: 2	Comparability: 2
	Outcome: 3	Outcome: 3

H. pylori: Helicobacter pylori; HD: Hemodialysis; PD: Peritoneal dialysis; ESRD: End-stage renal disease.