Infection in Children with Nephrotic Syndrome: Challenging Roles of Nurses and Discharge Planning with Family/Caregivers

Authors

  • Usanee Jintrawet School of Nursing, Panyapiwat Institute of Management
  • Tassaneeya Wangsachantanon School of Nursing, Punyapiwat Institute of Management

Keywords:

Childhood, Nephrotic syndrome, Discharge planning

Abstract

Nephrotic Syndrome (NS) is the renal disease affecting the permeability of the glomerular filtration barrier leading to massive proteinuria, including immunoglobulins and complement protein. Treatment of this disease with steroids with having action of immunosuppressive resulting in compromised their immunity. Thus, high risk of infection is anticipated. Nurses play essential roles in preventing infection among children with nephrotic syndrome during hospitalization. In addition, nurses should provide effective health education to caregivers for proper care of preventing infection after discharge from hospital to home.

This article aims to present the treatment of primary NS, nurses’ interventions to prevent infection during child’s hospitalization, and discharge planning with family or caregivers. Nurses can bring acquired knowledge of preventing infection to providing proper child’s care.

References

Croitoru A, Balgradean M. Treatment-associated side effects in patients with steroid-dependent nephrotic syndrome. Maedica 2022;17(2):285-90. doi: 10.26574/maedica.2022.17.2.285.

Robinson CH, Aman N, Banh T, Brooke J, Chanchlani R, Dhillon V, et al. Impact of childhood nephrotic syndrome on obesity and growth: a prospective cohort study. Pediatric Nephrology 2024;39(9):2667-77. doi: 10.1007/s00467-024-06370-0.

Chuaykaew B, Pichairat A, Ponsang S. Experiences of parents and grandparents caring for their children in hospital nephrotic syndrome. The Southern College Network Journal of Nursing and Public Health 2021;8(3):122-32. (in Thai)

Tagher G, Knapp L. Pediatric nursing: a case-based approach. Philadelphia, PA: Wolters Kluwer; 2019.

Hahn D, Samuel SM, Willis NS, Craig JC, Hodson EM. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database of Systematic Reviews 2020;2020(8):CD001533. doi: 10.1002/14651858.CD001533.pub6.

Lella G, Pecoraro L, Benetti E, Arnone OC, Piacentini G, Brugnara M, et al. Nutritional management of idiopathic nephrotic syndrome in pediatric age. Medical Sciences 2023;11(3):47. doi: 10.3390/medsci11030047.

Gũl I. Steroid therapy for children with idiopathic nephrotic syndrome: is a short-term or long-term treatment plan more effective?. Turkish Medical Student Journal 2023;10(3):93-8. doi: 10.4274/tmsj.galenos.2023.2022-12-2.

Lebel A, Kropach N, Ashkenazi-Hoffnung L, Huber-Yaron A, Davidovits M. Infections in children with nephrotic syndrome: twenty years of experience. Clinical Pediatrics 2020;59(7):692-8. doi: 10.1177/0009922820908583.

Jechel E, Nedelcu AH, Dragan F, Lupu VV, Starcea IM, Mocanu A, et al. Nutritional management of pediatric nephrotic syndrome regarding oxidative stress and antioxidant balance. Frontiers in Immunology 2025;16:1542735. doi: 10.3389/fimmu.2025.1542735.

Kalra S, Daryani H, Saxena A, Bhandari S, Sharma S. Infectious complications in children with nephrotic syndrome: can they be prevented?. Medical Journal Armed Forces India 2022;78(2):170-4. doi: 10.1016/j.mjafi.2020.10.010.

Mekonnen BA, Alene TD, Yimer YA, Lakew AM, Genet GB. Prevalence and associated factors of infection in children with nephrotic syndrome aged 2-18 years in the northwest and east Amhara region, Ethiopia: a multi-center cross-sectional retrospective study. BioMed Central Public Health 2024;24(1):1845 doi: 10.1186/s12889-024-19408-7.

Vivarelli M, Gibson K, Sinha A, Boyer O. Childhood nephrotic syndrome. Lancet 2023;402(10404):809-24. doi: 10.1016/S0140-6736(23)01051-6.

Clarin JD, Vivek G, Naik BM. Spectrum of infections in children with primary nephrotic syndrome in a tertiary care centre. International Journal of Academic Medicine and Pharmacy 2025;7(4):1046-51. doi: 10.47009/jamp.2025.7.4.200.

Worcestershire Acute Hospitals NHS Trust. Nursing management of nephrotic syndrome [Internet]. 2021 [cited 2025 Sep 28]. Available from: https://apps.worcsacute.nhs.uk/KeyDocumentPortal/Home/DownloadFile/1917

Patel PR, Bechmann S. Discharge planning [Internet]. 2023 [cited 2025 Aug 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557819/

Agency for Healthcare Research and Quality. IDEAL discharge planning overview, process, and checklist [Internet]. 2021 [cited 2025 Sep 2]. Available from: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Tool_1_IDEAL_chklst_508.pdf

Tran CL, Selewski DT, Oh GJ, Troost JP, Massengill SF, Al-Akash SI, et al. Pediatric immunization practices in nephrotic syndrome: an assessment of provider and parental knowledge. Frontiers in Pediatrics 2021;8:619548. doi: 10.3389/fped.2020.619548.

The Royal Children’s Hospital Melbourne. Clinical practice guidelines: nephrotic syndrome [Internet]. 2025 [cited 2025 Aug 20]. Available from: https://www.rch.org.au/clinicalguide/guideline_index/nephrotic_syndrome/

Angeletti A, Bruschi M, Bianchin S, Bonato I, Montobbio C, Verrina E, et al. Vaccines and disease relapses in children with nephrotic syndrome. Clinical Journal of the American Society of Nephrology 2021;16(6):937-8. doi: 10.2215/CJN.01890221.

The Royal Children’s Hospital Melbourne. Clinical practice guidelines: nephrotic syndrome [Internet]. 2025 [cited 2025 Dec 3]. Available from: https://www.rch.org.au/clinicalguide/guideline_index/Nephrotic_syndrome/

Charoensatsiri R. Nursing care of children with nephrotic syndrome: role of family participation. The Journal of Prapokklao Hospital Clinical Medical Education Center 2021;38(4):497-502. (in Thai)

Downloads

Published

2025-12-30

How to Cite

1.
Jintrawet U, Wangsachantanon T. Infection in Children with Nephrotic Syndrome: Challenging Roles of Nurses and Discharge Planning with Family/Caregivers. วารสารพยาบาลเกื้อการุณย์ [internet]. 2025 Dec. 30 [cited 2026 Jan. 3];32(2):327-36. available from: https://he01.tci-thaijo.org/index.php/kcn/article/view/282267

Issue

Section

Academic Article