Study of the Clinical Profile and Spectrum of Infections in Childhood Primary Nephrotic Syndrome

Background and Objectives: Infections are a common occurrence in children with nephrotic syndrome (NS) and affect the outcomes as they can lead to significant morbidity, poor response to therapy, and mortality. Materials and Methods: This observational study was conducted over a 2-year period in a tertiary care teaching hospital. Children in the age group of 1–14 years with signs and symptoms suggestive of infection were included. Detailed history, clinical examination, and microbiological analysis were done along with other investigations, wherever necessary. Results: Out of 80 cases, 43 presented as the first attack of NS. The incidence of infection was 66.3% ( n = 53). The incidence of infection among the first attack of NS was 60.5% and among relapsers was 73.9%. The mean age of presentation was 5.23 years with a male: female ratio of 1.7:1. Most of the cases belonged to the lower (45.2%) and upper lower (26.4%) class of the population. Among the infections observed, urinary tract infection (UTI) (41.5%) was most common, followed by acute respiratory infection and gastroenteritis. Peritonitis (14.7%) was observed only in relapse cases, and no cases were observed in cases of first attack. Among the cases of UTI, most of the cases (59%) are asymptomatic bacteriuria. Conclusions: We conclude that the incidence of infection in NS is 66.3% and a higher incidence is noted in relapsers and those patients on steroid or immunosuppressive therapy. UTI is the most common type of infection. All nephrotic children should be screened for UTI routinely for proper management and to avoid prolonged hospital stay, thereby to prevent long-term renal damage.