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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

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|March 5, 2010
PubMed

Insights

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.
Abstract

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