Comparison of biochemical changes in childhood nephrotic syndrome with or without urinary tract infection

ABSTRACT Introduction: Nephrotic syndrome (NS) is one of the most common renal system diseases in children. Presence of urinary tract infection (UTI) has important implications in early and prolonged remission in cases of NS. Objective: To determine the prevalence of UTI in newly diagnosed NS patients and compare the biochemical parameters of NS cases with or without UTI. Materials & Methods: This analytical cross-sectional study included 142 newly diagnosed nephrotic syndrome children aged 2-12 years from Pediatric Medicine department of Recep Tayyip Erdogan Hospital, Muzaffargarh from September 2024 to February 2025. Diagnosis of nephrotic syndrome was based on clinical examination and laboratory investigations. UTI was diagnosed using nitrite or leucocyte esterase tests. Data analysis was done through SPSS version 23. Quantitative comparisons were done through independent sample t-test at 5% significance level. Results: The mean age of the patients was 5.9 ± 2.5 years with 53.5% (n=76) male children. UTI was diagnosed in 64.8% (n=92) patients. The mean urea, creatinine, albumin and cholesterol were 26.2 ± 6.8 mg/dl, 0.3 ± 0.08 mg/dl, 2.0 ± 0.6 g/dl and 281.2 ± 32.1 mg/dl, respectively. Compared to children without UTI, serum albumin (1.6 ± 0.3 vs. 2.7 ± 0.2 g/dl, p < 0.001) was significantly less, and cholesterol (303.3 ± 10.3 vs. 240.5 ± 12.9 mg/dl, p < 0.001) was significantly high in children with urinary tract infection. Conclusion: UTI was highly prevalent in children newly diagnosed with nephrotic syndrome. Presence of UTI led to significant differences in serum albumin and cholesterol compared to no UTI.