Objective: This is a prospective, hospital based study over a period of one year, to examine the clinical profile of nephrotic children not on glucocorticoid therapy, but presenting with infection. Methods: Sixty-eight children with 76 episodes of nephrotic syndrome were enrolled during the study year. They were examined for evidence of infection using clinical and investigative criteria. The children were monitored daily for proteinuria and improvement of infection. After the infection was controlled, prednisolone therapy was started in those who were not already in remission. Results: Of the 76 episodes, eight were excluded from analysis as they had developed infection while they were on glucocorticoid therapy. Of the remaining 68 nephrotic episodes in 60 children, there was evidence of infection in 57 episodes (83.8%). Upper respiratory infection was the most common (28.0%) followed by urinary tract infection (22.8%), peritonitis (15.8%), pneumonia (14.0%), acute invasive diarrhoea (10.5%) and empyema (5.3%). Children with infection had significantly lower serum albumin and higher serum cholesterol compared to non-infected children. Of the 57 episodes with infection, remission occurred with control of infection alone in nine episodes (15.8%) and glucocorticoid therapy was not required. Conclusion: Infection is widely prevalent among Indian children presenting with episodes of nephrotic syndrome, even when they are not on glucocorticoid therapy. Some children may go into remission by control of infection alone. Among the infections, upper respiratory and urinary tract infections are the most common.

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The multi-dimensional impact on the quality of life (QOL) of families of children with the nephrotic syndrome (NS) has not been studied sufficiently in the literature. We aimed to study this aspect and the predictors of poor QOL among Indian families having children with NS. A cross-sectional study was conducted to compare the parents of children with chronic NS on treatment for at least one year with parents of a matched healthy control group. The parents of both groups were asked to complete the standard self-administered multi-dimensional questionnaire of Pediatric Quality of Life Inventory 4 (PedsQL TM ) Family Impact Module (FIM). Descriptive and analytical statistics were performed to compare scores between the two groups. Possible predictors of poor outcome in each of the summary scales among the cases were assessed by both univariate and multivariate analysis. The parents of 61 cases and 72 controls completed the PedsQL TM FIM questionnaire. The scores in each of the categories, namely FIM Total Scale Score, Parent HRQOL Summary Score, Family Functioning Summary Score and eight individual domains, were found to be significantly higher among controls. Female gender of the affected child was an independent risk factor for poor Family Functioning Summary Score. Also, presence of serious complications during the course of the disease independently predicted poor Total FIM and Parent HRQOL Summary Scores. Even a relatively benign and potentially curable chronic disorder in children, like the NS, can disturb the QOL of parents in multiple domains of functioning.