The risk of urinary tract infection in children with nephrotic syndrome
Abstract: Urinary tract
infections (UTI) may affect any part of the urinary system: the kidneys,
ureters, bladder, or urethra. Nephrotic syndrome (NS) is the most common
glomerular disorder in childhood, comprising a group of symptoms that include
proteinuria, hypoalbuminemia, hypercholesterolemia, and edema. The prevalence
of UTI in NS patients is high, around 25-66.7%. The increased prevalence of UTI
in NS is due to immunoglobulin loss, defective T cell function, the presence of
ascites, and relative malnutrition.
Objective To study the risk of UTI in children with NS.
Methods We performed a retrospective study of NS and UTI patients from
January 2004 to December 2013 in the Division of Nephrology at Prof. Dr. R.D.
Kandou Hospital, Manado. Data was collected from medical records. Diagnosis of
UTI was made based on urine culture results. Diagnosis of NS was made based on
the group of symptoms mentioned above. Analysis was done using Chi-square test with
SPSS version 22 software.
Results Of 74 NS patients, 34 (46%) had UTIs. During the same study
period, 117 patients had UTIs. NS was more common in boys (64.9%), while NS
with UTI was more common in girls (67.6%). The most common organisms causing UTI
in NS patients were Eschericia coli and Citrobacter diversus (23% each).
Imipenem and amikacin were most commonly used antibiotics to which the bacteria
were sensitive. Increased risk of UTI was significant in children with NS (OR
1.8; P=0.03).
Keywords: urinary tract
infection; nephrotic syndrome; children
Author: Patricia Y. Gunawan,
Adrian Umboh
Journal Code: jpkedokterangg160117