Urinary tract infection in nephrotic syndrome

Background, The aim was to study the frequency, etiology and predisposing factors of urinary tract infection (UTI) in children with nephrotic syndrome. Methods. A retrospective analysis of all children with nephrotic syndrome was made to determine the occurrence of infectious complications. Results. UTI was found to be the most common infection (40.26%); 49 episodes of culture-positive UTI were observed in 37 children. All 49 episodes occurred in patients who were initially considered to be steroid nonresponders or in relapse. Fourteen of the 49 episodes (28.6%) were asymptomatic. One child had Grade IV reflux and another had a ureteric calculus. The majority of the children had no underlying urinary tract malformations. The children with UTI had significantly lower serum albumin (P < 0.05) and higher serum cholesterol (P < 0.001) concentrations than the group of 206 children without infections. Non-Escherichia coli organisms accounted for 39% of the culture isolates. Conclusions. We believe that UTI is an important but often underdiagnosed infection in children with nephrotic syndrome.