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Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome.

Publication ,  Journal Article
Carpenter, SL; Goldman, J; Sherman, AK; Selewski, DT; Kallash, M; Tran, CL; Seamon, M; Katsoufis, C; Ashoor, I; Hernandez, J; Supe-Markovina, K ...
Published in: Pediatr Nephrol
February 2019

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.

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Published In

Pediatr Nephrol

DOI

EISSN

1432-198X

Publication Date

February 2019

Volume

34

Issue

2

Start / End Page

261 / 267

Location

Germany

Related Subject Headings

  • Venous Thromboembolism
  • Urology & Nephrology
  • Streptococcus pneumoniae
  • Risk Factors
  • Retrospective Studies
  • Prevalence
  • Pneumococcal Infections
  • North America
  • Nephrotic Syndrome
  • Male
 

Citation

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Carpenter, S. L., Goldman, J., Sherman, A. K., Selewski, D. T., Kallash, M., Tran, C. L., … Rheault, M. N. (2019). Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome. Pediatr Nephrol, 34(2), 261–267. https://doi.org/10.1007/s00467-018-4072-6
Carpenter, Shannon L., Jennifer Goldman, Ashley K. Sherman, David T. Selewski, Mahmoud Kallash, Cheryl L. Tran, Meredith Seamon, et al. “Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome.Pediatr Nephrol 34, no. 2 (February 2019): 261–67. https://doi.org/10.1007/s00467-018-4072-6.
Carpenter SL, Goldman J, Sherman AK, Selewski DT, Kallash M, Tran CL, et al. Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome. Pediatr Nephrol. 2019 Feb;34(2):261–7.
Carpenter, Shannon L., et al. “Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome.Pediatr Nephrol, vol. 34, no. 2, Feb. 2019, pp. 261–67. Pubmed, doi:10.1007/s00467-018-4072-6.
Carpenter SL, Goldman J, Sherman AK, Selewski DT, Kallash M, Tran CL, Seamon M, Katsoufis C, Ashoor I, Hernandez J, Supe-Markovina K, D’alessandri-Silva C, DeJesus-Gonzalez N, Vasylyeva TL, Formeck C, Woll C, Gbadegesin R, Geier P, Devarajan P, Smoyer WE, Kerlin BA, Rheault MN. Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome. Pediatr Nephrol. 2019 Feb;34(2):261–267.
Journal cover image

Published In

Pediatr Nephrol

DOI

EISSN

1432-198X

Publication Date

February 2019

Volume

34

Issue

2

Start / End Page

261 / 267

Location

Germany

Related Subject Headings

  • Venous Thromboembolism
  • Urology & Nephrology
  • Streptococcus pneumoniae
  • Risk Factors
  • Retrospective Studies
  • Prevalence
  • Pneumococcal Infections
  • North America
  • Nephrotic Syndrome
  • Male