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Abstract Nephrotic syndrome is a renal disease which may occur in pediatric and characterized by proteinuria, hypoalbuminemia and edema. Patients with NS received many medications aiming to treat their condition. These medications may increase the chance for being infected with H.pylori. H.pylori is a gram-negative bacterial pathogen that selectively colonizes the gastric epithelium. More than half of the population worldwide is persistently infected with H.pylori. The effect of H.pylori on nephrotic syndrome patients is not well established in the previous studies. The aim of the study to determine the incidence of Helicobacter Pylori infection in Pediatric patients with nephrotic syndrome. And the diagnostic value of non invasive tests (Urea Breath Test, stool antigen test and serology) in diagnosing Helicobacter pylori infection in the investigated nephrotic syndrome patients. This Prospective study was conducted on 50 subjects from patients with nephrotic syndrome who follow up in nephrology unit at Pediatric department of Menoufia university Hospital from December, 2020 until 28 February 2022. Inclusion criteria: Patients with Nephrotic syndrome (NS) are diagnosed clinically with proteinuria, hypoalbuminemia and oedema (155). Ages range from 3 years to 18 years old. Exclusion criteria: We exclude patients’ age less than three years or more than 18yrs. Other causes of edema (Cardiac, Nutritional, Hepatic, Renal, Endocrinal) Refusing and uncooperative patients or parents. After taking Informed consent all children were subjected to: Detailed history taking. Complete systemic examination: Anthropometric measurements including: Weight (Kg), Height (m) and Body mass index (BMI) (Weight (KG) ÷ Height (Metres²). Routine investigations: Complete blood count (CBC) to detect Hb, WBCs and platelets were measured by automated Sysmex XN-10 hematology Analyzer (Sysmex, Kobe, Japan). Blood Urea and serum creatinine were performed using an automatic biochemical analyzer (Erba chem7). Serum albumin, cholesterol were measured by automated chemistry AU680 analyzer (Beckman Coulter Inc; Brea, California, USA) Specific investigations: Urea breath test, Stool analysis (Rapid HpSA test) and Serum Helicobacter Pylori Antibodies. The summary of our study: o Prevalence of helicobacter was 22% among the studied patients. o There was no significant relation between H pylori infection and socio demographic and clinical data. Summary 47 o There was no correlation between steroid use and H.pylori infection however, H.pylori infection increased with NSAIDS use. o Leukocytosis was common in H.pylori patients. o There was no association between H.pylori and proteinuria or renal impairment. o Sensitivity, specificity, positive and negative predictive values and accuracy for serology in diagnosing of H.pylori in nephrotic syndrome children were 100%, 72%, 50% 100% and 78% respectively. o Sensitivity, specificity, positive and negative predictive values for stool antigen test in diagnosing of H.pylori in nephrotic syndrome children were 91%, 69%, 45% 96% and 74% respectively o Sensitivity, specificity, positive and negative predictive values and accuracy for UBT in diagnosing of H.pylori in nephrotic syndrome children were 82%, 72%, 45% , 93% and 74% respectively. |