Shannon L Carpenter1, Jennifer Goldman1, Ashley K Sherman1, David T Selewski2, Mahmoud Kallash3, Cheryl L Tran4, Meredith Seamon5, Chryso Katsoufis6, Isa Ashoor7, Joel Hernandez8, Katarina Supe-Markovina9, Cynthia D'alessandri-Silva10, Nilka DeJesus-Gonzalez11, Tetyana L Vasylyeva12, Cassandra Formeck13, Christopher Woll14, Rasheed Gbadegesin15, Pavel Geier16, Prasad Devarajan17, William E Smoyer3, Bryce A Kerlin3, Michelle N Rheault18,19. 1. Children's Mercy Hospital, Kansas City, MO, USA. 2. University of Michigan, Ann Arbor, MI, USA. 3. Nationwide Children's Hospital, Columbus, OH, USA. 4. Mayo Clinic, Rochester, MN, USA. 5. University of Utah, Salt Lake City, UT, USA. 6. University of Miami Miller School of Medicine, Miami, FL, USA. 7. LSU Health Sciences Center, New Orleans, LA, USA. 8. Kaiser Permanente, Los Angeles, CA, USA. 9. Stony Brook Children's Hospital, Stony Brook, NY, USA. 10. Connecticut Children's Hospital, Hartford, CT, USA. 11. University of Puerto Rico, San Juan, Puerto Rico. 12. Texas Tech University Health Sciences Center, Amarillo, TX, USA. 13. Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA. 14. Yale School of Medicine, New Haven, CT, USA. 15. Duke University, Durham, NC, USA. 16. Children's Hospital of Eastern Ontario, Ottawa, Ontario, USA. 17. Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 18. University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA. rheau002@umn.edu. 19. Division of Pediatric Nephrology, University of Minnesota, 2450 Riverside Ave. MB680, Minneapolis, MN, 55454, USA. rheau002@umn.edu.
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.
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.
Authors: Debbie S Gipson; Kassandra L Messer; Cheryl L Tran; Emily G Herreshoff; Joyce P Samuel; Susan F Massengill; Peter Song; David T Selewski Journal: Am J Kidney Dis Date: 2013-02-20 Impact factor: 8.860
Authors: Michelle N Rheault; Lei Zhang; David T Selewski; Mahmoud Kallash; Cheryl L Tran; Meredith Seamon; Chryso Katsoufis; Isa Ashoor; Joel Hernandez; Katarina Supe-Markovina; Cynthia D'Alessandri-Silva; Nilka DeJesus-Gonzalez; Tetyana L Vasylyeva; Cassandra Formeck; Christopher Woll; Rasheed Gbadegesin; Pavel Geier; Prasad Devarajan; Shannon L Carpenter; Bryce A Kerlin; William E Smoyer Journal: Clin J Am Soc Nephrol Date: 2015-10-08 Impact factor: 8.237
Authors: Cheryl L Tran; David T Selewski; Gia J Oh; Jonathan P Troost; Susan F Massengill; Samhar I Al-Akash; Shefali Mahesh; Rasheda Amin; Isa F Ashoor; Rahul Chanchlani; Mahmoud Kallash; Robert P Woroniecki; Debbie S Gipson Journal: Front Pediatr Date: 2021-02-05 Impact factor: 3.418
Authors: Shrey Purohit; Federica Piani; Flor A Ordoñez; Carmen de Lucas-Collantes; Colin Bauer; Gabriel Cara-Fuentes Journal: Front Med (Lausanne) Date: 2021-12-23