One Complication of Nephrotic Syndrome---Infection

Nephrotic syndrome is one of the most common types of kidney diseases in clinic and it is more common among children and adolescents. It usually occurs after upper respiratory tract infection, skin infection, over-tiredness or catching a cold.

Nephrotic syndrome will cause a lot of complications among which infection is a common one. This is because of the loss of large amount of immune globulin in urine and that the decrease of plasma protein will affect the formation of antibodies. The application of adrenal cortical hormones and cytotoxic medicines will further weaken the patients’ disease-resistance and make them more susceptible to infections such as skin infection, primary peritonitis, respiratory tract infection, urinary tract infection or even sepsis.

In addition, the continuous loss of protein will cause malnutrition and this will weaken the nonspecific immune response of the body and cause damages to the immune functions. A lot of transferrin and zinc will be lost in the urine. Transferrin is necessary for maintaining normal lymphocyte functions and the concentration of zinc is related to the synthesis of thymosin. Pleural effusion, ascites and severe edema can cause skin rupture and dilution of the humoral factors. These are all risk factors of nephrotic syndrome.

Before the invention of antibiotics, infection is one of the major causes of death especially among children and elderly patients. It was thought that immunosuppressant is one inducing factor of infection in nephrotic syndrome; however recent studies have found that the application of immunosuppressant can shorten the illness course of and help reduce the risk of infections. The main risk factors of infection in NS are the decrease of serum IgG (it is closely related to the level of albumin and 24-hour urinary protein quantitative) and the increase of creatinine level.

Some points you need to know:

1. Antibiotics can not be used at the same time with hormones or serious double infections will be caused.

2. In case of infections, sensitive and potent medicines should be used and at the same time avoid medicines and drugs that have renal toxicity.

3. Immunopotentiator can be used to prevent infections such as intramuscular injection of thymopeptide or intravenous infusion of globulin C.