Incidence and risk factors for major infections in hospitalized children with nephrotic syndrome

ABSTRACT Introduction: Children with nephrotic syndrome are at increased risk of infections because of disease status itself and use of various immunosuppressive agents. In majority, infections trigger relapses requiring hospitalization with increased risk of morbidity and mortality. This study aimed to determine the incidence, spectrum, and risk factors for major infections in hospitalized children with nephrotic syndrome. Methods: All consecutive hospitalized children between 1-12 years of age with nephrotic syndrome were enrolled in the study. Children with acute nephritis, secondary nephrotic syndrome as well as those admitted for diagnostic renal biopsy and intravenous cyclophosphamide or rituximab infusion were excluded. Results: A total of 148 children with 162 admissions were enrolled. Incidence of major infections in hospitalized children with nephrotic syndrome was 43.8%. Peritonitis was the commonest infection (24%), followed by pneumonia (18%), urinary tract infection (15%), and cellulitis (14%), contributing with two thirds of major infections. Streptococcus pneumoniae (n = 9) was the predominant organism isolated in children with peritonitis and pneumonia. On logistic regression analysis, serum albumin < 1.5gm/dL was the only independent risk factor for all infections (OR 2.6; 95% CI, 1.2-6; p = 0.01), especially for peritonitis (OR 29; 95% CI, 3-270; p = 0.003). There were four deaths (2.5%) in our study, all due to sepsis and multiorgan failure. Conclusions: Infection remains an important cause of morbidity and mortality in children with nephrotic syndrome. As Pneumococcus was the most prevalent cause of infection in those children, attention should be paid to the pneumococcal immunization in children with nephrotic syndrome.

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Plasma lipids as risk factors in relapsing nephrotic syndrome

Paediatrica Indonesiana ◽

10.14238/pi48.6.2008.322-6 ◽

2016 ◽

Vol 48 (6) ◽

pp. 322

Author(s):

Sitti Aizah Lawang ◽

Syarifuddin Rauf ◽

J. S. Lisal ◽

Husein Albar ◽

Dasril Daud

Keyword(s):

Risk Factors ◽

Nephrotic Syndrome ◽

Plasma Lipids ◽

Lipid Fraction ◽

Plasma Concentrations ◽

Increased Risk ◽

Significant Difference ◽

Remission Phase ◽

Blood Specimens

Background Nephrotic syndrome is primarily a pediatric disorderand is 15 times more common in children than in adults.Relapse rate after corticosteroid discontinuation is 39 - 59%.Hyperlipidemia is an important characteristic of nephroticsyndrome. The plasma concentrations of cholesterol, triglyceride,LDL, and VLDL are increased. Persistent hyperlipidemia afterremission can be found in frequent relapse nephrotic syndrome.Objective To determine plasma lipids as risk factor for relapsingnephrotic syndrome.Methods Thirty children with nephrotic syndrome were includedin this cohort study from March 2005 until June 2007 at WahidinSudirohusodo Hospital, Makassar. Thirty children without renal diseasewere enrolled as control. Blood specimens were collected to determineplasma lipids (cholesterol, triglyceride, LDL, and HDL) levels and LDUHDL ratio. Plasma lipids were examined in the acute and remissionphases. Follow up was carried out six months after remission todetermine the occurrence of relapsing nephrotic syndrome.Results Of 30 nephrotic syndrome patients, 12 had relapsed.There were highly significant differences in total cholesterol, HDL,LDL, triglyceride, and LDL/HDL ratio between acute nephroticsyndrome and nephrotic syndrome in remission. There were nosignificant differences in cholesterol, LDL, triglyceride, LDL!HDL ratio between nephrotic syndrome in remission and control.There was also no significant difference in the incidence in relapsebetween first attack and nephrotic syndrome with more than twoattacks. Acute lipid fraction levels were not risk factors in relapsingmephrotic syndrome. Remission triglyceride level was a risk factorin relapsing nephrotic syndrome with the prevalence risk of 5.2 andCI 95% of 1.06 to 25.3.Conclusion Persistent hypertriglyceride in remission phase isassociated with an increased risk of relapse in children withnephrotic syndrome.

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P0897RISK FACTORS FOR AVASCULAR BONE NECROSIS IN PATIENTS WITH LUPUS NEPHRITIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0897 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Daniela Monova ◽

Simeon Monov ◽

Assen Kamenov ◽

Vladislava Milenova

Keyword(s):

Risk Factors ◽

Lupus Nephritis ◽

Avascular Necrosis ◽

Immunosuppressive Agents ◽

Individual Risk ◽

Control Group ◽

High Dose ◽

Increased Risk ◽

Avascular Necrosis Of Bone ◽

Class Iv

Abstract Background and Aims Avascular necrosis of bone (AVN) is an important complication of systemic lupus erythematosus (SLE) and often causes serious physical disability. The aim of this study was to investigate the risk factors for symptomatic avascular necrosis of bone (AVN) in lupus nephritis (LN) patients. Method The records of 374 patients (43 males, 331 females) with kidney biopsy-proven LN were reviewed retrospectively. Symptomatic AVN cases were defined as those with at least one diagnosis of AVN. The patients with LN who did not have AVN were evaluated as a control group. To determine risk factors for AVN, clinical, laboratory and therapeutic variables were analyzed by logistic regression. Results Symptomatic AVN was present in 17 patients (4 males, 13 females, mean age of 27,4±6,7 years). Among the 17 patients, 28 joints presented AVN. 12 occurred in hips (2 bilateral), 6-in ankles, 4-in knees, 3-in shoulders and 1- in lumbar spine. In 9 patients AVN involved 2 or more joints. 14 patients were on steroids at the time of presentation of AVN. 2 patients were not on CS and 1 patient did not has documentation of steroid use. Meta-analysis demonstrates a significant increased risk of AVN in patients with high disease activity and class IV LN (p<0,005). LN patients with AVN showed an earlier onset age (p<0,05) and received significantly higher total cumulative corticosteroid dose. AVN was not significantly associated with use of immunosuppressive agents. Serositis, coagulation disorders, vasculitis, cigarette smoking were higher incidence in male with LN and AVN. Raynaud‘s phenomenon, autoimmune thyroiditis, arthritis, Sjögren’s syndrome, IgM anticardiolipin antibodies, antiphospholipid syndrome, Cushingoid body habitus were higher incidence in female with LN and AVN. Conclusion Many risk factors have been involved in the development of AVN in LN patients. AVN is prevalent in class IV LN and in younger patients. Since asymptomatic osteonecrosis may remain undetected, its true prevalence could be much higher than we reported. Multifocal lesions involving more than three anatomical sites are unusual. Corticosteroids are the principal risk factor, although some cases of AVN occur in relatively steroid naïve patients. Early detection of AVN is important because the prognosis depends of the stage and location of the lesion. An individual risk assessment for AVN development should be made prior to and during treatment for LN, especially in patients high dose corticosteroids.

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Surgical prehabilitation using mobile health coaching in patients with obesity: A pilot study

Anaesthesia and Intensive Care ◽

10.1177/0310057x20947731 ◽

2020 ◽

Vol 48 (5) ◽

pp. 373-380

Author(s):

Kasia Kulinski ◽

Natalie A Smith

Keyword(s):

Risk Factors ◽

Mobile Health ◽

Elective Surgery ◽

Text Message ◽

Cost Effective ◽

Text Messages ◽

Morbidity And Mortality ◽

Perioperative Morbidity ◽

Increased Risk ◽

Patient Health

Many patients spend months waiting for elective procedures, and many have significant modifiable risk factors that could contribute to an increased risk of perioperative morbidity and mortality. The minimal direct contact that usually occurs with healthcare professionals during this period represents a missed opportunity to improve patient health and surgical outcomes. Patients with obesity comprise a large proportion of the surgical workload but are under-represented in prehabilitation studies. Our study piloted a mobile phone based, multidisciplinary, prehabilitation programme for patients with obesity awaiting elective surgery. A total of 22 participants were recruited via the Wollongong Hospital pre-admissions clinic in New South Wales, Australia, and 18 completed the study. All received the study intervention of four text messages per week for six months. Questionnaires addressing the self-reported outcome measures were performed at the start and completion of the study. Forty percent of participants lost weight and 40% of smokers decreased their cigarette intake over the study. Sixty percent reported an overall improved health score. Over 80% of patients found the programme effective for themselves, and all recommended that it be made available to other patients. The cost was A$1.20 per patient per month. Our study showed improvement in some of the risk factors for perioperative morbidity and mortality. With improved methods to increase enrolment, our overall impression is that text message–based mobile health prehabilitation may be a feasible, cost-effective and worthwhile intervention for patients with obesity.

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Influence of Hypertension and Diabetes on Postoperative Outcomes In Cancer Patients Undergoing Moderate/High Risk Surgical Procedures

10.21203/rs.3.rs-184334/v1 ◽

2021 ◽

Author(s):

Lafayete William Ferreira Ramos ◽

Beatriz Nery Nascimento ◽

Gabriel Rossi Silva ◽

Marcos Vinícius Ferreira Ramos ◽

Barbara Cristina Ferreira Ramos ◽

...

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Cancer Patients ◽

Multiple Logistic Regression Analysis ◽

Diabetic Group ◽

Postoperative Outcomes ◽

Morbidity And Mortality ◽

Systemic Hypertension ◽

Surgical Time ◽

Increased Risk

Abstract Background: Systemic hypertension (HTN) and diabetes mellitus (DM) are believed to be risk factors for adverse postoperative outcomes in patients undergoing surgical interventions, but evidence is lacking. This retrospective study evaluated the effects of HTN and DM, alone or in combination, on postoperative outcomes of elective noncardiac surgery in cancer patients. Methods: Patients (n = 844) with malignancies, who underwent elective surgery at a tertiary hospital, were categorised into healthy (group A, n = 339), hypertensive (group B, n = 357), diabetic (group C, n = 21), and hypertensive and diabetic (group D, n = 127) groups. Preoperatively, all patients had systolic blood pressure ≤ 160 mmHg and plasma glucose level ≤ 140 mg/dl. Postoperative in-hospital morbidity and mortality were compared among groups. Results: Postoperative complications occurred in 22 (6.5%), 21 (5.9%), 2 (9.5%), and 11 (8.7%) patients in groups A, B, C, and D, respectively (p = 0.712). HTN (p = 0.538), DM (p = 0.990), and HTN+DM (p = 0.135) did not impact the occurrence of adverse events. Patients with higher surgical risk (ASA III or IV) and those with longer surgical time had higher morbidity and mortality (p = 0.001, p < 0.001, respectively). In multiple logistic regression analysis, ASA status and surgical time were independent risk factors for postoperative complications (both p < 0.001). Conclusion: Cancer patients with preoperative comorbidities, such as HTN and DM, alone or in combination, regardless of other characteristics, do not have an increased risk of adverse postoperative outcomes.Trial registration: Retrospectively registered.

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Abstract 14040: Hospitalizations for Respiratory Syncytial Virus and Vaccine Preventable Infections Following Pediatric Heart Transplantation: A PHIS Database Analysis

Circulation ◽

10.1161/circ.142.suppl_3.14040 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Emily A Hayes ◽

Stephen Hart ◽

Charitha Gowda ◽

Deipanjan Nandi

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Heart Transplantation ◽

Heart Transplant ◽

Immunosuppressive Agents ◽

Circulatory Support ◽

Transplant Recipients ◽

Increased Risk ◽

Pediatric Heart Transplantation ◽

Syncytial Virus

Introduction: Despite improvements in pediatric heart transplant outcomes, respiratory syncytial virus (RSV) and vaccine preventable infections (R/VPI) are a major cause of morbidity and hospital resource use. The frequency and risk factors for hospitalizations due to R/VPI in heart transplant recipients are unknown. Methods: Patients ≤18 years who underwent heart transplantation at hospitals contributing to the Pediatric Health Information System database from 9/2003 to 12/2018 were identified. The transplant hospitalization and subsequent hospitalizations for R/VPI through 12/2018 were analyzed. Risk factors for R/VPI hospitalizations were evaluated using negative regression binomial models adjusted for potential demographic and clinical confounders. Total hospital costs were determined adjusted for 2018 US $. Results: Of 3,815 transplant recipients, 681 (17.9%) had a R/VPI hospitalization during 23,746 available person-years of follow-up after transplant. There were 984 R/VPIs diagnosed during 951 hospitalizations, and 440 (44.7%) occurred in the first year after transplant (Figure). The most common causes were RSV (n=380; 38.6%), influenza (n=265; 26.9%), and pneumococcus (n=105; 10.7%). In adjusted analyses, there was an increased risk of R/VPI hospitalization in patients requiring mechanical circulatory support prior to transplant, those who received induction with ≥ 2 immunosuppressive agents, and patients <2 years old. The median length of stay for a R/VPI hospitalization was 4 days (interquartile range [IQR]: 2-8 days) with a median total cost of $11,081 (IQR: $6,215 - $24,322). Conclusions: Hospitalization for R/VPIs occurred frequently following pediatric heart transplantation and were associated with significant cost. Potential strategies to minimize R/VPI could include expanding vaccine use through accelerated immunization schedules in younger patients and routine monitoring of immunogenicity after vaccination.

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Delayed Varicella Zoster Virus (VZV) Infection Following Hematopoietic Cell Transplantation (HCT).

Blood ◽

10.1182/blood.v108.11.3366.3366 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3366-3366

Author(s):

Liton Francisco ◽

Mary Harton ◽

Can-Lan Sun ◽

Andrea R. Carter ◽

John Zaia ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Mycophenolate Mofetil ◽

Herpes Zoster ◽

Immunosuppressive Agents ◽

Unrelated Donor ◽

Varicella Zoster ◽

Increased Risk ◽

Autologous Hct ◽

Varicella Zoster Infection

Abstract Patients undergoing HCT are at an increased risk of developing primary and reactivated VZV infection, with the majority of reactivations occurring within the first year post-HCT. Short term use of acyclovir as prophylaxis has been shown to be effective in reducing VZV risk, however prolonged use of acyclovir as prophylaxis is controversial, and the long term incidence of delayed VZV infection, and hence the recommended duration of antiviral prophylaxis is not clear. To assess the incidence and risk factors associated with delayed VZV infection (occurring one or more years after HCT), we conducted a retrospective chart review of 1578 consecutive patients undergoing HCT at City of Hope Cancer Center between 1976 and 1998, and surviving one or more years after HCT. Diagnosis of VZV was based on the clinic note dictated by the physician, with validation using appropriate laboratory tests in those individuals diagnosed with VZV. Information on pre-transplant therapeutic exposures and post-transplant health complications was obtained via medical record abstraction. The median age at HCT was 35 years (range, 0.6–71.5), median length of follow-up 6.4 years, and the cohort included 934 males (59.2%). In total, 178 patients (11.3%) developed VZV infection after surviving at least one year after HCT (19 patients (1.2%) had primary VZV (chickenpox), 138 patients (8.7%) localized herpes zoster, and 21 patients (1.3%) disseminated herpes zoster). The overall cumulative incidence was 13.9% (95% Confidence Interval [CI], 11.6–16.2%) at 15 years from HCT for the first reported VZV infection developing one or more years after HCT. (autologous HCT: 10.2% [7.2–13.3%] at 10 years); allogeneic sibling donor HCT survivors: 14.2% [11.6–16.8%]; unrelated donor HCT: 21.5% [12.3–30.7%]). Multivariate analysis of the allogeneic transplant cohort showed that prophylaxis/treatment of GvHD with prednisone (Relative risk (RR), 2.14; 95% CI, 1.27 to 3.61) and Mycophenolate Mofetil (RR, 1.93; 95% CI, 1.08 to 3.45) were associated with increased risk. No risk factors were identified for the development of VZV among autologous HCT recipients by multivariate analysis. VZV infection is a frequent and significant source of morbidity after HCT (bacterial superinfection, scarring, post-herpetic neuralgia), and can be potentially fatal if disseminated. This study describes the magnitude of risk of delayed VZV infection in autologous and allogeneic HCT recipients and identifies the use of immunosuppressive agents such as Prednisone and Mycophenolate Mofetil as risk factors, suggesting the possible use of acyclovir as prophylaxis during prolonged periods of immune suppression. Incidence of Delayed Varicella Zoster in 1+ Year Survivors of HCT Incidence of Delayed Varicella Zoster in 1+ Year Survivors of HCT Delayed Varicella Zoster Infection in 1+ Year Survivors of HCT (by Type of Transplant) Delayed Varicella Zoster Infection in 1+ Year Survivors of HCT (by Type of Transplant)

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Risk factors of venous thromboembolism in patients with nephrotic syndrome: a retrospective cohort study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa134 ◽

2020 ◽

Author(s):

Kanna Shinkawa ◽

Satomi Yoshida ◽

Tomotsugu Seki ◽

Motoko Yanagita ◽

Koji Kawakami

Keyword(s):

Risk Factors ◽

Nephrotic Syndrome ◽

Cohort Study ◽

Venous Thromboembolism ◽

Lupus Nephritis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Vein Thrombosis ◽

Female Sex ◽

Increased Risk

Abstract Background Nephrotic syndrome is associated with an increased risk of venous thromboembolism (VTE). However, the risk factors of VTE in nephrotic syndrome, other than hypoalbuminemia and severe proteinuria, are not well established. Therefore we aimed to investigate the risk factors of VTE in patients with nephrotic syndrome. Methods This retrospective cohort study used data from a Japanese nationwide claims database. We identified patients ≥18 years of age hospitalized with nephrotic syndrome. Through multivariable logistic regression, we determined the risk factors of VTE in patients with nephrotic syndrome during hospitalization. Results Of the 7473 hospitalized patients with nephrotic syndrome without VTE, 221 (3.0%) developed VTE. In the VTE group, 14 (6.3%), 11 (5.0%) and 198 (89.6%) patients developed pulmonary embolism, renal vein thrombosis and deep vein thrombosis, respectively. We found that female sex {odds ratio [OR] 1.39 [95% confidence interval (CI) 1.05–1.85]}, body mass index (BMI) ≥30 [OR 2.01 (95% CI 1.35–2.99)], acute kidney injury [AKI; OR 1.67 (95% CI 1.07–2.62)], sepsis [OR 2.85 (95% CI 1.37–5.93)], lupus nephritis [OR 3.64 (95% CI 1.58–8.37)] and intravenous corticosteroids use [OR 2.40 (95% CI 1.52–3.80)] were associated with a significantly higher risk of developing VTE. Conclusions In patients with nephrotic syndrome, female sex, BMI ≥30, AKI, sepsis, lupus nephritis and intravenous corticosteroid use may help evaluate the risk of VTE.

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Clinical spectrum and predictive risk factors of major infections in hospitalized children with nephrotic syndrome

Indian Pediatrics ◽

10.1007/s13312-013-0214-x ◽

2013 ◽

Vol 50 (8) ◽

pp. 779-781 ◽

Cited By ~ 15

Author(s):

Payyadakkath Ajayan ◽

Sriram Krishnamurthy ◽

Niranjan Biswal ◽

Jharna Mandal

Keyword(s):

Risk Factors ◽

Nephrotic Syndrome ◽

Clinical Spectrum ◽

Hospitalized Children ◽

Predictive Risk

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Risk Factor of Hepatic Veno-Occlusive Disease: Analysis of Clinical Data of 5024 Patients Extracted from the Database of the Japan Marrow Donor Program.

Blood ◽

10.1182/blood.v108.11.2970.2970 ◽

2006 ◽

Vol 108 (11) ◽

pp. 2970-2970

Author(s):

Miwa Sakai ◽

Kazuteru Ohashi ◽

Takuya Yamashita ◽

Hideki Akiyama ◽

Hisashi Sakamaki

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Stem Cell ◽

Clinical Data ◽

Univariate Analysis ◽

Disease Status ◽

Occlusive Disease ◽

Blood Type ◽

Hematopoietic Stem ◽

Increased Risk

Abstract Hepatic veno-occlusive disease (VOD) is one of the most serious complication of hematopoietic stem cell transplantation (HSCT). Various factors have been identified as increasing the risk of hepatic VOD, but few of them have been associated with a significantly increased risk. We retrospectively analyzed the clinical data of 5024 transplant recipients (median age28, range 0–68) which extracted from the Japan Marrow Donar Program. The diagnosis of VOD was made according to the McDonald’s criteria, and 324 out of 4833 patients (6.7%) were eventually diagnosed with VOD. The possible risk factors based on the previous studies were counted on an initial univariate analysis, and cumulated significant factors were further analyzed for their potential value for VOD development in multivariate analysis. Variables correlated with an increased risk of VOD were: time of transplant >2 times (relative risk (RR) 2.7; p=0.006), pretransplant disease status (RR 2.3; p=0.000), prior liver disease (RR 2.1; p=0.017), ABO blood type mismatch (RR1.7; p=0.000). In patients receiving either busulfan or melphalan for conditioning increased VOD risk (RR 1.5 and 1.8; p=0.007 and 0.002, respectively). In our multivariate analysis, stem cell source, and prophylactic use of heparin and Ursodiol had no significant effect on VOD development. This analysis might contribute to revise the previously reported risk factors for VOD and the data could be used to know which patients might be suitable subjects for new trials for VOD prevention.

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Infections Are Associated with Higher Risk of Venous Thromboembolism in Hospitalized Children with Nephrotic Syndrome

Blood ◽

10.1182/blood.v128.22.3811.3811 ◽

2016 ◽

Vol 128 (22) ◽

pp. 3811-3811

Author(s):

Jennifer Goldman ◽

Shannon L Carpenter ◽

Ashley K Sherman ◽

David Selewski ◽

Mahmoud Kallash ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Logistic Regression ◽

Regression Analysis ◽

Nephrotic Syndrome ◽

Intensive Care ◽

Venous Thromboembolism ◽

Streptococcus Pneumoniae ◽

Hospitalized Children ◽

Median Hospital

Abstract Introduction: Although it is known that children with nephrotic syndrome (NS) are at greater risk for certain complications, the frequency of these complications and predisposing risk factors are poorly defined. In particular, nephrotic syndrome has long been considered a hypercoagulable state. Risk for development of venous thromboembolism (VTE) is known to be increased in the setting of an active infection. The objective of this study was to determine the prevalence of infection and VTE among a cohort of hospitalized children with NS, and the association of these complications on outcomes. Methods: Records of hospitalized children with NS admitted to any of 17 participating pediatric hospitals across North America from 2010-2012 were included. Data including demographics, clinical pattern of NS, renal biopsy results, number of hospitalizations, nephrotoxic medication usage, infection and VTE history were recorded. Descriptive statistics were used to determine prevalence of infection and VTE. Wilcoxon rank sum was used to perform comparisons between groups. Logistic regression analysis was utilized to determine predictors of VTE development. Results: Seven-hundred thirty hospitalizations occurred among 370 children. One-hundred forty-eight children (40%) had at least 1 infection with a total of 211 infectious episodes; 11 (3%) had VTE. Those with infection were more likely to have VTE (p = 0.0457). Infections associated with VTE were C. difficile (1 subject), methicillin sensitive S. Aureus (2), Streptococcus pneumoniae (1), and unknown (3). There were no differences between those with and without infection regarding gender or ethnicity. Those with infection were younger at NS diagnosis (3.0 vs. 4.0 years; p = 0.008), and steroid resistant NS was more highly associated with infection than all other clinical diagnoses (steroid-sensitive NS, steroid-dependent NS, other) (p = 0.003). The most common types of infections encountered included peritonitis (23%), pneumonia (22%), and bacteremia (16%). Bacterial pathogens (Streptococcus pneumoniae 41%, Escherichia coli 16%, Clostridium difficile 10%) were most commonly identified. Children with VTE, infection, or both, also required significantly more days in hospital. The median hospital stay for those without infection was 5 days vs. 10 in those with infection (p< 0.0001). Similarly, median hospital days for those without VTE were 6 days as compared to 22 in those with VTE (p < 0.0001). Of those with infection, 13% had an ICU stay compared with 3.3% of those without. Those with VTE also had a median of 4 days in the intensive care unit as compared to 0 days in those without VTE (p < 0.0001). In a logistic regression analysis, only the number of ICU days was predictive of the presence of VTE (OR 1.074, 95% CI 1.013 - 1.138). Conclusions: Children with NS who are hospitalized have high rates of infection. While the rate of VTE was not high in this cohort, presence of VTE was associated with infection. Both infection and VTE were associated with longer hospitalizations and intensive care unit stays. Streptococcus pneumoniae remains the most commonly identified bacterial pathogen in children with nephrotic syndrome, though methicillin sensitive S. Aureus was identified in 2 of 11 patients with VTE. Further studies are needed to identify potentially modifiable risk factors that could minimize these complications in this already high risk population. Disclosures No relevant conflicts of interest to declare.

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