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만성신장병 환자에서 PPI를 기본으로 한 Helicobacter pylori 제균 삼제요법의 효과 및 안전성

만성신장병 환자에서 PPI를 기본으로 한 Helicobacter pylori 제균 삼제요법의 효과 및 안전성
Other Titles
Efficacy and safety of proton pump inhibitor-based triple therapy of Helicobacter pylori eradication in patients with chronic kidney disease
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대학원 의학과
Chronic kidney disease, Helicobacter pylori, Eradication
이화여자대학교 대학원
Background/Aims: The efficacy of triple therapy for the eradication of Helicobacter pylori (H. pylori) has been documented in patients with normal renal function. The purpose of this study was to investigate the efficacy of PPI-based triple eradication therapy in chronic kidney disease (CKD) patients with H. pylori infection. Subjects and Methods: This study included 18 patients with CKD (GFR <60 mL/min/1.73 m2 for more than 3 months, irrespective of the presence or absence of kidney damage) and 18 age- and sex-matched patients with normal creatinine group(control), who had peptic ulcer disease with H. pylori infection. We evaluated the efficacy and the safety of the regimens including PPI-based triple therapy for H. pylori eradication, retrospectively. The combination of omeprazole 20 mg twice daily, amoxicillin 1,000 mg twice daily, and clarithromycin 500 mg twice daily was used for 1 week, mainly. Eradication of H. pylori was checked by means of histology, rapid urease test, or 13C urea breath test, 4~8 weeks after the eradication therapy. Results: All except 1 patient (1 patient, CKD group) had successful eradication of H. pylori (94.4%, CKD group versus 100%, control group). For the CKD patients, the glomerular filtration rate after eradication therapy remained unchanged after the one month of H. pylori eradication (33.3±8.6 mL/min/1.73 m2 vs 34.1±10.8 mL/min/1.73 m2, p=0.60). Conclusion: The PPI-based triple therapy for H. pylori eradication in the CKD patients was as efficacious as the normal creatinine group, without adverse effect on renal function. Key words: Chronic kidney disease, Helicobacter pylori, Eradication;고용량의 항생제를 포함하는 삼제요법을 만성신장병 환자의 H. pylori 제균을 목적으로 사용할 때 신독성을 포함한 부작용이 고려되어야 하나, 만성신장병 환자에서 H. pylori 제균 요법에 대한 연구는 제한적이며, 현재까지의 연구 결과를 보면 사용 약제의 용량 및 제균율은 다양하다. 또한 아직까지 만성신장병 환자를 대상으로 한 삼제 요법의 제균율과 안정성에 대한 국내 보고는 없는 실정이다. 이에 본 연구에서는 만성신장병 환자에서 PPI를 기본으로 한 H. pylori 제균 삼제요법의 효과와 안정성을 정상 신기능을 가진 군과 비교하여 알아보고자 하였다.
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