SPECTRUM OF INFECTIONS IN INDIAN CHILDREN WITH NEPHROTIC SYNDROME

We conducted a retrospective analysis of infections in 154 children (1 14 boys, 40 girls) with nephrotic syndrome who satisfied the Internati onal Study of Kidney Disease in Children criteria. Their mean age at o nset of symptoms was 6.2 years (range 6 months to 16 years) and the me an duration of follow-up was 32 months (range 6-55 months). One or mor e infectious complications were observed in 59 of the 154 children (38 %), with urinary tract infection being the commonest (13.7%), followed by pulmonary tuberculosis (10.4%), peritonitis (9.1%), skin infection s (5.2%), upper respiratory infections (5.2%), lower respiratory tract infections (3.9%) and pyomeningitis (0.6%), There were 3 deaths, the mortality in 2 patients being attributable to infections, There was no significant difference between children who developed infection and t hose who didn't in terms of age of onset, sex, duration of disease, se rum creatinine, blood urea nitrogen and 24-h proteinuria. However, the children who developed infectious complications had significantly hig her serum cholesterol levels (P < 0.01) and lower serum albumin levels (P < 0.02). The frequency of infections was higher in children who we re frequent relapsers, steroid dependent and subsequent non-responders (28/60) compared with infrequent relapsers and initial non-responders (29/94).