Disease Characteristics and Determinants of Infection Among Children with Nephrotic Syndrome

Background: Nephrotic syndrome is a common pediatric renal disorder frequently complicated by infections, which significantly increase morbidity and may influence disease progression. Identifying disease characteristics and determinants of infection is essential for improving management strategies. Methods: This cross-sectional study was conducted in the Department of Pediatric Nephrology at Dhaka Shishu (Children) Hospital from January 2010 to November 2010. A total of 115 children aged 1–13 years diagnosed with nephrotic syndrome were enrolled. Detailed clinical evaluation and laboratory investigations were performed. Data were analyzed to determine the pattern of infections and associated risk factors and a p-value 0.05 was considered statistically significant. Results: The majority of children were between 2–6 years of age, with a mean age of 5.29±2.7 years. Most patients were from rural areas (73.91%) and had poor socioeconomic backgrounds (52.17%). Relapse was observed in 50.44% of cases, while 17.39% were steroid dependent and 15.64% were steroid resistant. Almost all children presented with generalized swelling, proteinuria and oliguria; 26.10% had fever. Urinary tract infection was the most common infection (44.35%), followed by pneumonia (6.09%) and septicemia (4.35%). Steroid dependence (p=0.03), steroid resistance (p=0.001), generalized swelling (p=0.02), low serum albumin (p=0.02) and lower protein–creatinine ratio (p=0.01) were significantly associated with infection. Conclusion: Infection remains a major complication of childhood nephrotic syndrome, particularly among steroid-dependent and steroid-resistant cases. Early identification of high-risk patients is crucial to reduce infectious morbidity and improve outcomes.