Major infections in children suffering from nephrotic syndrome- experience of a tertiary care centre

Abstract

Background and Objectives.Infections are an important cause of morbidity and mortality in children with nephrotic syndrome (NS). There is significant variation in the type of infection reported and the influence of patient or treatment parameters on the occurrence of infections is also not well studied. Based on this background, we intended to study the occurrence and pattern of infections in children suffering from nephrotic syndrome.Methodology: We conducted this prospective observational study over 1 year from April 2019 to March 2020 at department of Pediatrics, NMCH, Patna, Bihar including children of 1-12 years age with diagnosis of nephrotic syndrome.All such children were evaluated for type and pattern of major infections.Results: Over the study period, we enrolled 103 children. Mean age of the study group was 5.7 years. Incidence of major infections was 35.9%. The most common infections were UTI (24.3%), pneumonia (21.6%), acute diarrhea (16.2%) and peritonitis (10.8%). Fever (64.95%) was the most common presenting feature followed by respiratory symptoms and abdominal symptoms (32.4% each). There was no statistically significant association between occurrence of infection and age, gender, duration of the disease, remission status, type of NS and immunosuppressive treatment. Duration of hospital stay in children with infection was significantly higher in comparison to children without infection (12.2 versus 8.3 days, p < 0.001). However, there was no statistically significant difference between occurrence of infection in the initial episode of NS and subsequent episodes. Conclusion:Infections are common in children with NS. UTI, pneumonia, diarrhea and peritonitis were the common major infections. Infections contribute significantly to morbidity in such children.