Physical development and idiopathic nephrotic syndrome in children

Abstract

INTRODUCTION. Study of physical development (PD) of children with idiopathic nephrotic syndrome (INS) includes mainly assessment of body height and weight during corticosteroid (CS) therapy; specifics of these criteria before and after the treatment are not sufficiently studied. THE AIM: to study PD of children with INS debut during CS therapy and upon its completion.PATIENTS AND METHODS. A retrospective analysis of PD was performed in 89 patients with INS in Voronezh Regional Children's Clinical Hospital No.1 during 1998-2014 using method of Z-score of body height and weight in comparison with regional standards.RESULTS. At the INS debut body height of 38.2% of the children and body weight of 41.2% accordingly were less than those of healthy children, p<0.001. Children with steroid-sensitive nephrotic syndrome (SSNS) had no difference in body height Z-score during CS therapy (0.17±1.06) and upon its completion (0.28±1.22), p=0.794. Body height was less in steroiddependent patients (SDNS) compared to SSNS patients. Z-score body weight values in children with SSNS were higher during maximum doses of CS (0.94±1.59) and returned to previous values after the therapy (-0.24±1.33), р=0,040. Patients with a frequent relapsing SSNS and SDNS had overweight and obesity remained after prednisone treatment (p=0.009).CONCLUSION. Physical development of children with INS has differences associated with CS therapy. Since body height and weight of children with INS were different from the norms before CS therapy, this could be influenced by genetic factors, which to be studied further. The results can be used to prognose CS therapy influence on PD of patients and assess prognosis of INS.