#2135 Infectious complications in glomerular disease: experience from a tertiary care centre in Eastern India

Abstract Background and Aims Infections are the Achilles heel in glomerular disease. They can complicate the course of glomerular diseases, adding to both morbidity and mortality. Method We conducted a retrospective, observational study among adult patients with biopsy proven glomerular disease with estimated GFR (eGFR) >15 ml/min/1.73 m2 . Patients who underwent a kidney biopsy and were diagnosed with glomerular disease and subsequently treated in department of Nephrology between March 2022–December 2024 were included in the study. We evaluated the demographic characteristics, type of immunosuppression and other treatment, type of infection, infectious agent, infection related hospitalization and mortality in our study. Results We evaluated 279 patients (146 females, 133 males) with a median follow up of 14.4 months. Mean age of the patients was 39 ± 21 years. The histopathological diagnosis was podocytopathy in 28.3% patients, lupus nephritis in 25.8%, IgA nephropathy in 22.9%, membranous nephropathy in 22.2%, idiopathic MPGN in 7.1% of the patients. Majority of patients had received one or more immunosuppression (89%). Among patients treated with immunosuppression, 89.6% received steroids, 53.7% received cyclophosphamide, 22% received mycophenolate mofetil, 12% received rituximab, 6.2% received tacrolimus. 40.8 % patients received antimicrobial prophylaxis. Infectious complications were seen in 28.7% patients receiving immunosuppression. Among those with infections, most common site of infection was upper respiratory tract (43.3%), skin and soft tissue (31.3%), lower respiratory tract (14.4%), gastrointestinal tract (4.8%), genitourinary tract (4.8%) and bone and joints (1.2%). Bacterial infections were the most common, 6.4%and 4.3% of patients receiving immunosuppressive treatment had fungal (most commonly dermatophytosis) and viral infections respectively (most commonly herpes zoster), while 1.7% had parasitic infection. Among those with infection 20 patients (28.1%) required hospitalisation. 11 (3.7%) patients died during the course of their treatment, majority of them (72.7%) were attributed to infection. Conclusion Almost one-third of patients requiring immunosuppressive treatment developed infections during the course of their illness, morbidity associated with infection was also higher. Patient education regarding infection prevention measures and close monitoring are of paramount importance in patients on immunosuppressive therapy.