Urinary Tract Infection in Nephrotic Syndrome: A Hospital Based Cross-Sectional Study

Abstract

Background: Urinary Tract Infection (UTI) is a common infection in nephrotic syndrome and have a propensity for long term renal damage. It may be an important cause of poor steroid response. The objective is to study the frequency and etiological organisms of urinary tract infection in idiopathic nephrotic syndrome children. Methods: This Comparative cross-sectional study was conducted in the Pediatric ward of Chittagong Medical College Hospital, Chittagong from 01.01.2009 to 31.12.2009. 52 nephrotic syndrome children diagnosed by serum albumin, serum cholesterol and 24 hours total urinary protein or protein creatinin index were included. After elaborate clinical evaluation, urine for R/M/E and C/S was done in all patients. Data regarding pyuria, hematuria, etiological organisms were analyzed by statistical method. Results: UTI was found in 30.8% nephrotic children and in majority cases (68.8%) they were asymptomatic. Male female ratio among UTI patients was 1:1. Mean serum cholesterol in nephrotic syndrome with UTI was higher than that of children without UTI (418.94 mg/dl vs 352.03 mg/dl, p value < 0.05).Pyuria had poor association with definite UTI (p value > 0.05). E-coli was the commonest organism isolated in urine culture followed by klebsiella. Conclusion: UTI is one of the most common infections in nephrotic syndrome and may be asymptomatic. It should be screened in every nephrotic child routinely.

Urinary Tract Infection in Nephrotic Syndrome - A study of 62 cases at Faridpur Medical College Hospital

“…In our study regarding clinical profile of the patient it was observed that asymptomatic was 68.0% and symptomatic was 32.0% which is comparable to the study of Barua et al where 68.8% were asymptomatic 11 .…”

“…Barua et al study observed that Male: Female ratio 1:1. In case of nephrotic syndrome without UTI (Group B), out of 36, 61.1% (n=22) were male and 38.9% (n=14) were female 11 .…”

Peer Review #2 of "Moderation effects of food intake on the relationship between urinary microbiota and urinary interleukin-8 in female type 2 diabetic patients (v0.1)"

“…was related to infections including phlegmon, peritonitis, endocarditis, meningitis, septicemia, and UTI (Cooper et al, 2005;Biswas et al, 2014;Horowitz et al, 1990). Barua et al found that nephritic syndrome patients with higher serum cholesterol were more susceptible to UTI than those with normal serum cholesterol, which might be because high cholesterol concentrations suppress lymphocyte function (Barua et al, 2016 Manuscript to be reviewed (Rochelson et al, 2007;Weglicki et al, 1992), and a previous rodent model study demonstrated that magenesium-deficiency elevated circulating levels of inflammatory cytokines (Weglicki et al, 1992). There were several limitations in our present study.Firslty,the participants were only from Zhejiang Province, China.…”

Moderation effects of food intake on the relationship between urinary microbiota and urinary interleukin-8 in female type 2 diabetic patients

“…was related to infections including phlegmon, peritonitis, endocarditis, meningitis, septicemia and UTI (Cooper et al, 2005;Biswas, Fitchett & O'Hara, 2014;Horowitz et al, 1990). Barua et al (2017) found that nephritic syndrome patients with higher serum cholesterol were more susceptible to UTI than those with normal serum cholesterol, which might be because high cholesterol concentrations suppress lymphocyte function. With regard to magnesium, its intake had an enhancing effect on the relationship between the relative abundance of Comamonas and IL-8 concentration.…”