Pattern of Respiratory Tract Infections in Nephrotic Syndrome Presented with Relapse.

Abstract

Nephrotic syndrome is a common renal disorder in the pediatric age group and the incidence of relapse in nephrotic syndrome is about 60.0-90.0%. Infection is an important contributing factor for the relapse of nephrotic syndrome. It may result progressive CKD. The objective of this study was to find out the pattern of Respiratory tract infections in nephrotic syndrome children presented with relapse. Children of both sexes, age range 1-12 years with relapse cases of nephrotic syndrome was admitted into the Department of Pediatrics, Dr M R Khan Shishu Hospital & ICH, Bangladesh included in this study until the desired number of 35 children were fulfilled. This cross sectional observational study was conducted into the Department of Pediatrics, Dr M R Khan Shish Hospital & ICH, Dhaka, Bangladesh from February 2020 to August 2020. The patient was enrolled according to inclusion and exclusion criteria. Data was collected through a structured questionnaire. Data were analyzed using computer-based programmed statistical package for social science (SPSS) for windows version 23.0. A total of 23 cases suffering from Nephrotic syndrome with relapse were studied. This study shows the mean age of children with infection was 5.91±3.17 years. Maximum (56.1%) were male children and 43.9% were female children. It was observed that (65.71%) of the subjects had one or more respiratory tract infections. The most common presentations of nephrotic syndrome patients during admission were swelling (100%), fever (82.60%) and cough (69.56%). Pneumonia was the commonest infection in this study (52.17%), then bronchiolitis (17.39%), tonsillitis (13.04%), pharyngitis (8.69%) and (4.34%) were otitis media and sinusitis. Streptococcus was isolated in 1(4.34%) patient and Covid-19 in 3(13.04%) patients. These results indicate major infections remain a crucial complication of nephrotic syndrome in children, especially during relapses. The relationship between infection and relapse showed a higher rate of relapse in pneumonia, bronchiolitis &tonsillitis. This study will give proper guidance to physicians to counsel and treat the patients accordingly.