Should All Dialysis Patients be Screened and Treated for Helicobacter Pylori Preemptively before Renal Transplant?

A 55-year-old Saudi woman who was on chronic dialysis for the past three years and received a live related kidney transplant four months ago, complained of epigastric pain and vomiting. She was on triple immunosuppressive therapy consisting of corticosteroids, cyclo­sporine and mycophenolate mofetil. The prertrnsplant upper gastrointestinal (GI) endoscopy showed mild erythematic non­erosive gastritis in the antrum, and the biopsy showed mild chronic gastritis due to H. pylori infection. She was treated with oral proton pump inhibitor only and remained asympto­matic. The repeat of the upper GI endoscopy revealed severe erosive antral gastritis, erosive duodinitis and anterior wall duodenal ulcer. The biopsy of the antral mucosa revealed severe gastritis due to H. pylori infection and the patient was treated with triple therapy (amoxycillin, clarithromycin and omeprazole) for two weeks to which she responded very well.