The risk of urinary tract infection in children with nephrotic syndrome

  • Patricia Y. Gunawan Department of Child Health, Sam Ratulangi University Medical School/Prof.Dr. R.D. Kandou Hospital, Manado
  • Adrian Umboh Department of Child Health, Sam Ratulangi University Medical School/Prof.Dr. R.D. Kandou Hospital, Manado
DOI: https://doi.org/10.14238/pi56.4.2016.238-41
Keywords: urinary tract infection, nephrotic syndrome, children

Abstract

Background Urinary tract infections (UTI) may affect any part of the urinary system: the kidneys, ureters, bladder, or urethra. Nephrotic syndrome (NS) is the most common glomerular disorder in childhood, comprising a group of symptoms that include proteinuria, hypoalbuminemia, hypercholesterolemia, and edema. The prevalence of UTI in NS patients is high, around 25-66.7%. The increased prevalence of UTI in NS is due to immunoglobulin loss, defective T cell function, the presence of ascites, and relative malnutrition.


Objective To study the risk of UTI in children with NS.


Methods We performed a retrospective study of NS and UTI patients from January 2004 to December 2013 in the Division of Nephrology at Prof. Dr. R.D. Kandou Hospital, Manado. Data was collected from medical records. Diagnosis of UTI was made based on urine culture results. Diagnosis of NS was made based on the group of symptoms mentioned above. Analysis was done using Chi-square test with SPSS version 22 software.


Results Of 74 NS patients, 34 (46%) had UTIs. During the same study period, 117 patients had UTIs. NS was more common in boys (64.9%), while NS with UTI was more common in girls (67.6%). The most common organisms causing UTI in NS patients were Eschericia coli and Citrobacter diversus (23% each). Imipenem and amikacin were most commonly used antibiotics to which the bacteria were sensitive. Increased risk of UTI was significant in children with NS (OR 1.8; P=0.03).


Conclusion Children with NS are at significantly increased risk of UTIs.

References

1. Rusdidjas, Ramayati R, Tambunan T. Infeksi saluran kemih. In: Noer MS, Soemyarso NA, Subandiyah K, Prasetyo RV, Alatas H, Tambunan T, et al, editors. Kompendium nefrologi anak. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011. p. 131-8.
2. Rusdidjas, Ramayati R. Infeksi saluran kemih. In: Alatas H, Tambunan T, Trihono PP, Pardede SO, editors. Buku ajar nefrologi anak. 2nd ed. Jakarta: Ikatan Dokter Anak Indonesia; 2002. p. 142-61.
3. Noer MS. Sindrom nefrotik idiopatik. In: Noer MS, Soemyarso NA, Subandiyah K, Prasetyo RV, Alatas H, Tambunan T, et al, editors. Kompendium nefrologi anak. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011. p. 72-87.
4. Davis ID, Avner ED. Nephrotic syndrome. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: W. B. Saunders Company; 2004. p. 1753-7.
5. Adeleke SI, Asani MO. Urinary tract infection in children with nephrotic syndrome in Kano, Nigeria. Ann Afr Med. 2009;8:38-41.
6. Moorani KN, Mukesh R. Spectrum of infections in children with newly diagnosed primary nephrotic syndrome. Pak J Med Res. 2012;51:10-14.
7. Ritonga S. Hubungan infeksi saluran kemih dengan sindrom nefrotik resisten steroid pada anak [thesis]. Yogyakarta: Fakultas Kedokteran Universitas Gadjah Mada; 2012.
8. Arcana INP. Infeksi saluran kemih pada sindrom nefrotik [thesis]. Semarang: Fakultas Kedokteran Universitas Diponegoro; 1999.
9. Subandiyah K. Pola dan sensitivitas terhadap antibiotik bakteri penyebab infeksi saluran kemih anak di RSU dr. Saiful Anwar, Malang. J Kedokteran Brawijaya. 2004;XX:57-61.
10. Jodal U, Hansson S. Urinary tract infection. In: Holliday AM, Barrat TM, Avner ED, editors. Pediatric nephrology. 3rd ed. Philadelphia: William & Wilkins; 1994. p. 950-86.
11. Ahmed SM, Swedlund SK. Evaluation and treatment of urinary tract infections in children. Am Fam Physician. 1998;57:1573-80.
12. Kher KK, Leichter HE. Urinary tract infection. In: Kher KK, Makker SP, editors. Clinical pediatric nephrology. New York: McGraw-Hill Inc; 1992. p. 277-321.
13. Smellie JM, Normand ICS. Management of urinary tract infection. In: Postlethwaite RJ, editor. Clinical pediatric nephrology. Bristol: Wright; 1986. p. 372-93.
14. Adeyodin OT, Ojuawo IA, Odimayo MS, Anigilaje EA. Urinary tract infections in children with primary nephrotic syndrome and acute glomerulonephritis. West Afr J Med. 2010;29:235-8.
Published
2016-08-31
How to Cite
1.
Gunawan P, Umboh A. The risk of urinary tract infection in children with nephrotic syndrome. PI [Internet]. 31Aug.2016 [cited 24Nov.2024];56(4):238-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/772
Issue
Vol 56 No 4 (2016): July 2016
Section
Articles

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Received 2016-10-03
Accepted 2016-10-03
Published 2016-08-31