The relationship between Helicobacter pylori and chronic kidney disease: update 2020.

A number of studies has confirmed that the epidemiology of Helicobacter pylori (H. pylori) is changing worldwide, with a decrease especially in developed Countries. Nevertheless, since this Gram-negative bacterium infects almost 50% of the world's population, it remains a global problem. Beyond its role in the pathogenesis of the main gastroduodenal diseases, including gastritis, peptic ulcer and gastric cancer, H. pylori has been suspected to be involved in several extra-gastroduodenal disorders. Patients with chronic kidney disease (CKD) present gastric mucosal injuries and dyspepsia more often than the general population. However, the reported relationship between CKD and H. pylori infection is conflicting. In fact, in this population these conditions have a multifactorial pathogenesis and H. pylori infection could play a limited role in their development. Nevertheless, while it seems that the prevalence of the bacterium is lower in patients with CKD than in controls, H. pylori has been shown to be associated to an increased occurrence of proteinuria in patients with type 2 diabetes mellitus. This narrative review analyzes the results of recent literature in this field with particular focus on data reported by meta-analyses.