Urinary tract infection in nephrotic children: A cross-sectional study

Abstract

Background and Objectives: Nephrotic syndrome, characterized by the presence of heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia, is a common renal disorder in pediatric population. The aim of this study was to find out the prevalence of urinary tract infection (UTI) in nephrotic syndrome, bacterial etiologies, and antibiotic sensitivity pattern. Subjects and Methods: After matching the criteria, 82 cases were taken for this prospective, single-center, observational study. The diagnosis was confirmed by bacterial culture. This is an institution-based, cross-sectional, descriptive observational study. All newly diagnosed and relapse cases of nephrotic syndrome based on the inclusion exclusion criteria were included in the study. Respondent was either of the parents or caregiver of the study subjects. Analysis of all data was done by appropriate statistical software (SPSS-23). Results: Among 82 participants evaluated with nephrotic syndrome, 29.3% of participants had UTI, majority (66.7%) were asymptomatic, and 33.3% were symptomatic. Significant microscopic hematuria was found in 20.7% of study subjects and significant pyuria was found in 58.54%. Majority (33.3%) of UTIs were caused by Escherichia coli, followed by Klebsiella 25%, Proteus 16.7%, and Staphylococcus aureus 12.5%, and Citrobacter, Acinetobacter, and mixed growth were found in 4.2% each. The mean serum cholesterol of group with UTI was 422.13 ± 34.65 and group without UTI was 307.43 ± 26.13. The variation among the two groups was found to be statistically significant (P = 0.0001). Conclusions: The children with nephrotic syndrome are frequently predisposed to UTI, and in most cases, it is asymptomatic and often undiagnosed. Higher serum cholesterol level may predispose the nephrotic child for UTI.