TY - JOUR
T1 - Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome
AU - Carpenter, Shannon L.
AU - Goldman, Jennifer
AU - Sherman, Ashley K.
AU - Selewski, David T.
AU - Kallash, Mahmoud
AU - Tran, Cheryl L.
AU - Seamon, Meredith
AU - Katsoufis, Chryso
AU - Ashoor, Isa
AU - Hernandez, Joel
AU - Supe-Markovina, Katarina
AU - D’alessandri-Silva, Cynthia
AU - DeJesus-Gonzalez, Nilka
AU - Vasylyeva, Tetyana L.
AU - Formeck, Cassandra
AU - Woll, Christopher
AU - Gbadegesin, Rasheed
AU - Geier, Pavel
AU - Devarajan, Prasad
AU - Smoyer, William E.
AU - Kerlin, Bryce A.
AU - Rheault, Michelle N.
N1 - Publisher Copyright:
© 2018, IPNA.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - 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.
AB - 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.
KW - Focal segmental glomerulosclerosis
KW - Infection
KW - Minimal change disease
KW - Nephrotic syndrome
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85052975288&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052975288&partnerID=8YFLogxK
U2 - 10.1007/s00467-018-4072-6
DO - 10.1007/s00467-018-4072-6
M3 - Article
C2 - 30194664
AN - SCOPUS:85052975288
SN - 0931-041X
VL - 34
SP - 261
EP - 267
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 2
ER -
