Prevalence of helicobacter pylori infection among Egyptian children with nephrotic syndrome: a single center study.

Background: Increasing attention has been paid for the possible role of helicobacter pylori (H.pylori) infection in nephrotic syndrome (NS) pathogenesis. Objectives: We investigated the frequency, possible role and risk factors of H. pylori among NS children. Methods: We conducted a cross-sectional comparative study in a university-affiliated children’s hospital, Egypt from January 2017 to January 2019. We enrolled 100 children with primary NS (NS group) and 100 healthy controls. All patients were assessed for gastritis symptoms, response to steroid therapy, dose and duration of steroid therapy. H. pylori infection was investigated using H.pylori stool antigen (HpSA) test. Renal histopathology results were retrieved. Chi-square, Fisher exact and Mann-Whitney tests were used for statistical analysis. Results: With regards to HpSA test results, neither statistically significant difference was found between NS and control groups (p =0.193) nor between steroid sensitive and steroid resistant NS subgroups (p =0.286). Mesangioproliferative glomerulonephritis and minimal change disease (MCD) were the most common renal histopathology findings in NS group. Minimal change disease (MCD) was the most frequent histopathology finding in H.pylori positive patients (9 patients, 45%) with statistically significant difference in comparison to H.pylori negative patients (p =0.013). High dose steroid was associated with an increased risk of H.pylori infection among NS children (Odds ratio [OR] = 3.8; 95% confidence interval [CI] = 1.3-11.3). Conclusions: The current study negated the role of H.pylori infection in primary NS pathogenesis. High dose steroid is associated with an increased risk for H.pylori among NS children.

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