CLINICAL SPECTRUM AND PREDICTIVE RISK FACTORS FOR INFECTIONS IN CHIL-DREN WITH NEPHROTIC SYNDROME

Abstract

Introduction: Our study aimed to study the incidence of major infections in nephrotic syndrome & the risk factors for major infections & their etiological spectrum.

Methods: This was an observational study to find out the incidence of major infection in all cases of nephrotic syndrome who were admitted with either first attack or relapse of nephrotic syndrome from November 2016 to October 2017 (1 year) at tertiary care centre attached with SMIMER medical college.

Results: Prevalence of nephrotic syndrome was 1.0 % from all indoor admissions at out centre. Our study showed that one third of the patients with nephrotic syndrome had major infection. In our study cases of nephrotic syndrome presented at mean age of 6.40 ± 3.34 years. There was a preponderance of nephrotic syndrome in male (1.1:1). Epidemiologically major infections in nephrotic syndrome was more common in age group of 1-5 years & mainly in male children (1.3:1). In present study, 65% of cases showed presence of anemia. Mean hemoglobin level was low with statistical significance in patients with major infection.

Conclusion: Our study showed that one third of the patients with nephrotic syndrome had major infection. The mean value of serum protein & serum albumin was low in children with major infection with statistical significance as compared to children without infection. Cholesterol, triglyceride, HDL & LDL level were low with statistical significance in children with major infection. Patients with past history of infection were more likely to have major infections. Most common major infection was pneumonia followed by UTI. Most common chest radiograph finding in pneumonia was patchy consolidation. Most common organism causing UTI was E. coli & Klebsiella.