Analysis of Factors Related to Urinary Tract Infections in Children with Nephrotic Syndrome and Preliminary Exploration of Treatment Strategies.

Abstract

Objective: Nephrotic syndrome (NS) is a common disorder in children that significantly affects their health. Children with NS often suffer from urinary tract infections (UTIs), which are common complications that not only complicate treatment but also worsen prognosis. The aim of this study was to analyze the factors associated with UTIs in children with NS and investigate potential intervention strategies.

Methods: Ninety-four pediatric patients with NS who were admitted to our hospital from January 2023 to October 2023 were selected. Among these patients, 34 children with UTIs were included in the research group, and the remaining 60 with NS alone were included in the control group. The children's clinical data, such as age, sex, and NS course, were collected. Factors affecting the occurrence of UTIs in children with NS were analyzed via logistic regression, and future treatment strategies were discussed. Furthermore, children with UTIs were analyzed for the presence of pathogenic bacteria to summarize the clinical profile of these pathogens.

Results: Logistic regression analysis revealed that the duration of hormone use (odds ratio (OR): 3.841, 95% CI: 2.141-5.862), type of antibiotics used (OR: 1.841, 95% CI: 1.541-5.249), length of hospital stay (OR: 1.461, 95% CI: 1.124-1.667), albumin (ALB; OR: 0.623, 95% CI: 0.384-0.857, p = 0.015), immunoglobulin G (IgG; OR: 0.534, 95% CI: 0.264-0.836, p = 0.005), and 24-hour urine protein concentration (24 h Pro; OR: 6.242, 95% CI: 2.642-10.645) were independent relevant factors for UTIs in children with NS (p < 0.05). The analysis of pathogenic bacteria revealed that gram-negative bacteria were the most prevalent bacteria in children with UTIs (28 out of 34).

Conclusions: In the future, in the clinical treatment of pediatric NS patients, it is necessary to strictly control the dosage of hormones and antibiotics and pay attention to the dynamic changes in the ALB, IgG, and 24 h Pro levels to prevent UTIs.