Detection Of Overgrowth Of Small Intestinal Bacteria In Children With Primary Nephrotic Syndrome By Methane-hydrogen Breath Test

Objective:To evaluate the small intestinal bacterial overgrowth(SIBO)in children with primary nephrotic syndrome(PNS)by methane-hydrogen breath test(MHBT).Methods:A total of 30 children with PNS(PNS group)and 34 subjects with physical examination(control group)were recruited from March 2021 to March 2022.A MHBT was used to detect the growth of bacteria in the subjects’ small intestines.Then the association between PNS and SIBO was analyzed by collecting relevant clinical data.Results:1.Sixteen children with PNS had SIBO,and the prevalence of SIBO was 53.3%(95%CI:11.1%-89.7%).By comparison,26.5%of the children in control group had SIBO.The difference between two groups was statistically significant(χ2=4.831 4,P=0.027 9).2.Pearson correlation analysis showed that the change in H2 in exhaled air after lactulose administration was correlated with serum cholesterol level in SIBO-positive patients in the case group(P<0.05).There was no significant correlation between gas change and serum albumin,fibrinogen,leukocyte count,neutrophil percentage,hemoglobin and platelet count(all P>0.05).Multivariate Logistic analysis showed that gender,age,permanent residence,mode of delivery,whether PNS was initially treated or not,and BMI were not significantly correlated with SIBO in children with PNS(all P>0.05).3.There were not all statistically significant in CH4 and H2 levels in breath samples between the PNS group and the control group at each time point(P<0.05 or P>0.05).There were significant differences in CH4 and H2 levels in breath samples between SIBO-positive and SIBO-negative children in PNS group at each time point(all P<0.05)4.The leukocyte count in children with nephrotic syndrome complicated with SIBO was significantly lower than that in those without SIBO(F=6.279 7,P=0.020 1).There were no significant differences in albumin,cholesterol,24-hour urinary protein,fibrinogen,neutrophil percentage,hemoglobin,platelet count,and CRP between the two groups(all P<0.05).Conclusion:Children with PNS are more likely to develop SIBO,and the cholesterol concentration and leukocyte count levels in these children are significantly increased,which provides some ideas for the study of the pathogenesis of PNS and provides certain targets for the treatment of PNS.