{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:22:59Z","timestamp":1788841379050,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with idiopathic minimal change nephrotic syndrome (MCNS) undergoing immunosuppressive therapy are susceptible to infectious complications. Study specifically focusing on adult population's infectious complications is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected 101 adult patients with biopsy\u2010proven idiopathic MCNS and analysed for the infectious complications. Published literatures were also reviewed aiming to evaluate the feasibility of prophylactic antibiotic treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Infectious complications developed in 17 of 101 (16.8%) patients, with pneumonia (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), cellulitis\/fasciitis (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) and urinary tract infection (UTI) (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) being the dominant diseases, and <jats:italic>Gram\u2010negative bacilli<\/jats:italic> the main cause. AKI stage \u22652 (Hazard ratio\u00a0=\u00a06.1; 95% CI: 1.2\u201331.9, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.031) and non\u2010remission by treatment (Hazard ratio\u00a0=\u00a04.4; 95% CI: 1.2\u201315.6, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.023) were the two independent risk factors relevant to developing infectious complications. Review of 16 published literatures and our data showed that even no prophylactic antibiotic therapy, only one case of <jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia developed among the 1787 accumulative cases of MCNS. In contrast, 16 (44%) of acute flare cases were reported among the 36 patients with positive hepatitis B surface antigen that did not receive antiviral prophylactic therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Advanced acute kidney injury and non\u2010remission by treatment are the risk factors toward developing infectious complications in adult MCNS undergoing immunosuppressive therapy. It appears unnecessary to use prophylactic antibiotic for <jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia or other bacterial infections, while screening and prophylactic therapy for hepatitis B and latent tuberculosis are critical for patients in prevalent area.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.14119","type":"journal-article","created":{"date-parts":[[2022,10,9]],"date-time":"2022-10-09T09:22:51Z","timestamp":1665307371000},"page":"953-961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Infectious complications in adult patients with idiopathic minimal change nephrotic syndrome undergoing immunosuppressive therapy"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1151-9628","authenticated-orcid":false,"given":"Chih\u2010Yang","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Kaohsiung Veterans 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