Spectrum of Infections in Nephrotic Syndrome of Childhood

Nephrotic syndrome is the clinical manifestation of glomerular diseases associated with heavy (nephrotic-range) proteinuria. Nephrotic range proteinuria is defined as proteinuria >3.5 g/24 hr or a urine protein : creatinine ratio >2. The triad of clinical findings associated with nephrotic syndrome arising from the large urinary losses of protein are hypoalbuminemia ( 2.5 g/dL), edema, and hyperlipidemia (cholesterol >200 mg/dL). Infection is a major complication in children with Nephrotic syndrome. Patients with relapse will have increased susceptibility to bacterial infection because of urinary losses of immunoglobulins & properdin factor B, defective cell mediated immunity, immunosuppressive therapy , malnutrition & edema or ascitis acting as potential culture medium. There is paucity of literature regarding spectrum of infections in childhood nephrotic syndrome from the rural areas of India. Hence the need for this study. Nephrotic syndrome affects 1-3 per 100,000 children <16 yr of age. Without treatment, nephrotic syndrome in children is associated with a high risk of death, most commonly from infections.