FREQUENCY OF URINARY TRACT INFECTION IN CHILDREN WITH NEPHROTIC SYNDROME

Abstract

Background

UTIs are common and a major complication in children with nephrotic syndrome, which is an illness characterized by proteinuria, hypoalbuminemia, and edema. The infections are very common among children undergoing immunosuppressive treatment because of impaired immunity, urinary stasis, and alterations in the urinary tract anatomy. It is important to prevent further complications like pyelonephritis or renal failure by detecting and treating the problem early enough.

Objectives

The objective of the study was to identify the prevalence of urinary tract infections in children with nephrotic syndrome, the risk factors that contribute towards UTIs, as well as to learn the effect of UTIs on the progression of the disease and its response outcomes.

Place and Duration of study. From June 2025 to October 2025 Paediatrics Department Balochistan Institute of Child Health & Services Quetta. Balochistan

Methodology

The was a retrospective study that reviewed the medical records of 100 children who had a diagnosis of nephrotic syndrome in a tertiary care hospital. The collected information was age, gender, clinical presentation, immunosuppressive therapy, and frequency of disease relapse. All children with UTI underwent urine cultures, and the results of the microbiological analyses were discussed. The statistical analysis was carried out in SPSS, as the chi-square tests and t-tests were used with p < 0.05 as the significance level.

Results
Of the 100 children, 27 (27%) had UTIs, with a higher incidence in girls (18%) compared to boys (9%). The mean age of the patients was 8.5 years (SD = 2.5). UTIs were more common among those receiving immunosuppressive therapy (22/27), particularly steroids (19/27). Escherichia coli was the most common pathogen (58%). A significant association was found between steroid use and increased UTI risk (p < 0.01). Recurrent relapses also increased UTI frequency (p < 0.05). Most UTIs were successfully treated with antibiotics, with 90% of cases recovering fully. One child developed pyelonephritis, but no cases of renal failure were reported.

Conclusion

Study points out a strong correlation between UTIs and nephrotic syndrome in children who are immunosuppressed through treatment or more frequently with recurrent attacks. Early screening and treatment are necessary to prevent complications, particularly in high-risk patients, to maximize disease management and prevent renal complications.