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Published on: May 6, 2018
Behavioural abnormalities in children with nephrotic syndrome.
Om P Mishra1, Biswanath Basu, Shashi K Upadhyay
1Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. opmpedia@yahoo.co.uk
Summary
Glucocorticoid therapy for childhood nephrotic syndrome is linked to behavioral issues. Frequent relapsers showed more problems, and higher steroid doses correlated with increased behavioral abnormalities.
Area of Science:
- Pediatric Nephrology
- Child Psychology
- Pharmacology
Background:
- Glucocorticoid therapy for nephrotic syndrome in children can cause adverse effects, including behavioral problems.
- Idiopathic nephrotic syndrome (INS) requires long-term management, often involving steroids.
Purpose of the Study:
- To assess behavioral changes in children with idiopathic nephrotic syndrome across different subgroups.
- To investigate the relationship between behavioral problems and cumulative steroid dose in these patients.
Main Methods:
- A prospective, hospital-based study involving 131 children and adolescents (1.5-15 years) with steroid-responsive INS.
- Comparison with 50 age- and gender-matched healthy controls using the Achenbach Child Behaviour Checklist.
- Patients were sub-grouped by age and disease status (first attack, infrequent relapser, frequent relapser/steroid-dependent).
Main Results:
- Elevated mean behavioral abnormality scores were observed in most dimensions for INS patients compared to controls, excluding rule-breaking behavior.
- Children aged 1.5-5 years who were frequent relapsers or steroid-dependent exhibited the highest scores, particularly for sleep problems.
- A significant association was found between total and individual behavioral scores and the cumulative prednisolone dose.
Conclusions:
- Behavioral abnormalities are a significant concern in children with nephrotic syndrome, particularly following steroid therapy.
- Clinical practice should include monitoring and addressing behavioral issues in pediatric nephrotic syndrome patients.
- The cumulative steroid dose appears to be a contributing factor to behavioral changes.
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