The Effects ofHelicobacter pyloriEradication on Proteinuria in Patients with Primary Glomerulonephritis

Abstract

Background. Membranous nephropathy (MN) is a common cause of nephrotic syndrome. In most cases it is idiopathic, while it may also be secondary to many diseases. In this study, prevalence ofH. pyloriinfection and the effects ofH. pylorieradication on proteinuria levels were investigated.Methods. Thirty five patients with MN (19 male), 12 patients with IgA nephropathy (4 male) and 12 patients with focal segmental glomerulosclerosis (FSGS) (8 male) were studied. The presence ofH. pyloriantigen was investigated in renal tissues obtained by biopsy, and the effects ofH. pylorieradication on proteinuria levels were investigated.Results. Immunohistochemistry withH. pyloriantigen revealed no positive staining in the glomeruli of all patients. 19 patients (54%) with MN, 10 (83%) with IgA nephropathy and 4 (33%) with FSGS were positive forH. pyloristool antigen test(P=0.045). Patients withH. pyloriinfection were administered eradication therapy (lansoprazole, 30 mg twice daily, plus amoxicillin, 0.75 g twice daily, plus clarithromycin, 250 mg twice daily, for 14 days). Before the eradication therapy the mean proteinuria of patients with MN, IgA nephropathy and FSGS were 2.42 ± 3.24 g/day, 2.12 ± 1.63 g/day and 1.80 ± 1.32 g/day, respectively. Three months after eradication, baseline proteinuria levels of patients with MN significantly decreased to 1.26 ± 1.73 g/day(P=0.031). In all three groups there were no significant differences with regard to serum creatinine, albumin and C-reactive protein levels before and after eradication therapy.Conclusions. The eradication ofH. pyloriinfection may be effective to reduce proteinuria in patients with MN, while spontaneous remission of MN could not be excluded in this patient cohort. This trial is registered withNCT00983034.