Title

Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome.

Document Type

Article

Publication Date

2-2019

Identifier

DOI: 10.1007/s00467-018-4072-6; PMCID: PMC6628263

Abstract

BACKGROUND: Nephrotic syndrome (NS) results in hypercoagulability and increased risk of infection. Furthermore, infection increases the risk of venous thromboembolism (VTE). Our objective was to determine the prevalence of infection, VTE, and the associated outcomes among a cohort of hospitalized children with NS.

METHODS: All children with NS admitted to 17 pediatric hospitals across North America from 2010 to 2012 were included. Prevalence of infection and VTE was determined. Wilcoxon rank-sum and logistic regression were performed.

RESULTS: Seven-hundred thirty hospitalizations occurred among 370 children with NS. One-hundred forty-eight children (40%) had ≥ 1 infection (211 episodes) and 11 (3%) had VTE. Those with VTE had infection more frequently (p = 0.046) and were younger at NS diagnosis (3.0 vs. 4.0 years; p = 0.008). The most common infectious pathogen identified was Streptococcus pneumoniae. The median hospital length of stay for those with infection [10 vs 5 days (p < 0.0001)] or VTE [22 vs 6 days (p < 0.0001)] was longer than those without either complication. Of those with infection, 13% had an intensive care unit (ICU) stay compared with 3.3% of those without infection. Median ICU stay was 4 days in those with VTE compared to 0 days in those without (p < 0.001). By logistic regression, only the number of ICU days was associated with VTE (OR 1.074, 95% CI 1.013-1.138).

CONCLUSIONS: Hospitalized children with NS have high rates of infection. Presence of VTE was associated with infection. Both were associated with longer hospitalizations and ICU stays.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

34

Issue

2

First Page

261

Last Page

267

MeSH Keywords

Child; Child, Preschool; Female; Humans; Intensive Care Units; Length of Stay; Logistic Models; Male; Nephrotic Syndrome; North America; Pneumococcal Infections; Prevalence; Retrospective Studies; Risk Factors; Streptococcus pneumoniae; Venous Thromboembolism

Keywords

Focal segmental glomerulosclerosis; Infection; Minimal change disease; Nephrotic syndrome; Venous thromboembolism

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