Risk of Chronic Kidney Disease after Early and Late Helicobacter Pylori Eradication in Patients with Peptic Ulcer Disease: A Population-Based Cohort Study in Taiwan Guei-Fen Chiu 1* , Yu-Han Chang 1 , Den-Chang Wu 1,2,4 , Ming-Tsang Wu 4 and Hugo You-Hsien Lin 1,3 1 Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Taiwan 2 Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan 3 Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan 4 Division of Family Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan * Corresponding author: Guei Fen Chiu, Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Taiwan, Tel: 0929659621; E-mail: 0870023@gmail.com Received date: May 22, 2017; Accepted date: June 26, 2017; Published date: July 03, 2017 Copyright: © 2017 Chiu GF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Helicobacter pylori play a central role in the development of chronic gastritis, gastric and duodenal ulcers, and gastric cancer. The risk of upper gastrointestinal bleeding in patients with chronic kidney disease (CKD) or end stage renal disease is reportedly higher than that in the general population. The effects of early and late H. pylori eradication on kidney disease rates warrant further investigation. Methods: We conducted a population-based study by using Taiwan’s National Health Insurance Research Database of 1 million beneficiaries. The enrolled-date of this database is from January 1, 2000 to December 31, 2009. We compared the incidence and risk of CKD in 3,689 patients in the early H. pylori eradication cohort with those in 4,298 patients in the late H. pylori eradication cohort. Results: The adjusted hazard ratio (HR; 95% confidence interval (CI)=1.17–1.77) for subsequent CKD was 1.44- fold higher in the late eradication cohort than in the early eradication cohort. In subgroup analysis, in patients aged 40–65 years, the HR was 1.55 (95% CI=1.14–2.10) and in those aged >65 years, the HR was 1.41 (95% CI=1.03– 1.93). Conclusion: This nationwide population-based cohort study provides evidence that patients with late eradication of H. pylori are at higher risk of CKD than those with early eradication of H. pylori. Keywords: Helicobacter pylori; Chronic kidney disease; Nationwide population-based cohort study Introduction Chronic kidney disease (CKD) is a growing public health problem worldwide [1,2]. It is crucial to evaluate risk factors in patients with CKD because of higher all-cause mortality and cardiovascular disease [3]. In addition, it is unclear how the major causes of CKD [4], hypertension and type 2 diabetes mellitus (DM), account for its development or progression. Hyperuricemia, dyslipidemia, obesity, and infammation were the other risk factors but only partially accounted for individual diferences [5-8]. Some epidemiological studies have reported a signifcant association between Helicobacter pylori infection and certain cardiovascular disease risk factors, suggesting that chronic infammation caused by H. pylori promotes atherosclerosis and cardiovascular disease [9]. However, no study has investigated the relationship between H. pylori and CKD. We evaluated the efects of the time of H. pylori eradication and development of CKD in Taiwan. Tis nationwide population-based cohort study assessed the possibilities patients with increasing risk of CKD. Te original data were derived from Taiwan’s National Health Insurance Research Database (NHIRD). Methods Study population Tis retrospective cohort study analyzed data from the NHIRD, which was established by the NHI Bureau of the Department of Health. A random sample of one million benefciaries was created by the National Health Research Institutes in 2000, and the reimbursement data between 1996 and 2010 (Longitudinal Health Insurance Database (LHID) 2000) are available. Tis database is contracted with 97% of hospitals and clinics in Taiwan which covers 99% of the 23 million Taiwanese residents (Figure 1). Chiu et al., Biol Med (Aligarh) 2017, 9:4 DOI: 10.4172/0974-8369.1000402 Research Article Open Access Biol Med (Aligarh), an open access journal ISSN: 0974-8369 Volume 9 • Issue 4 • 1000402 B i o l o g y a n d M e d i c i n e ISSN: 0974-8369 Biology and Medicine