Spectrum of infection in children with steroid responsive nephrotic syndrome

Infection in patients with nephrotic syndrome has been described as hallmark of idiopathic nephrotic syndrome. The aim of present article is to study the clinical profile of infections in children with steroid responsive nephrotic syndrome and correlation of serum albumin and serum cholesterol level with episodes of infection in children with steroid responsive nephrotic syndrome. The predictive value of C-reactive protein in cases of suspected infection in children with nephrotic syndrome was also taken into consideration. This cohort study comprised of minimum of 62 children from November 2008 to October 2010 with steroid responsive Nephrotic syndrome presenting with symptoms of infections to Hindu Rao Hospital Emergency/ward/Nephrology clinic and follow up of children attending the nephrology clinic at monthly interval. Among steroid responsive nephrotic syndrome children we found most common infection was upper respiratory tract infection (65.1%) followed by acute diarrhoea 23.15%, Urinary tract infection 2.34%, pneumonia 1.67%, tuberculosis 1.34%, septicaemia + peritonitis1.34% , chronic suppurative otitis media 1%, miscellaneous 4.36 %. On evaluation of biochemical parameter of nephrotic syndrome our study revealed total protein, albumin were significantly (p<0.05) lower and cholesterol was significantly higher on comparing infection with no infection during relapse. CRP was positive during pneumonia, septicaemia, peritonitis. Infections are more common in frequent relapse and steroid dependent nephrotic syndrome children. CRP is useful as a marker during invasive bacterial infection.