Growth in children with nephrotic syndrome

To assess the long-term growth status and the effects of steroid therapy on the linear growth of nephrotic children, growth patterns were analyzed in 52 patients who had been followed for 2 to 12 (5.51 +/- 2.82) years. They were divided into 2 groups: (1) Group A had less favorable clinical courses, this included 29 children with frequent relapsing, steroid-dependent, and steroid-resistant nephrotic syndromes; (2) Group B, consisting of 23 nephrotic children with occasional or no relapse. When assessed by a growth velocity index (GVI) and a change in standard deviation score of height (delta SD score), 24 patients (46%) were found to have growth impairment; of these, 21 (88%) belonged to Group A. The mean adult height of 6 Group A patients was subnormal when compared to normal adults, while the value for 6 Group B patients was normal. Based on covariance analysis, steroid usage of more than 6 months per year with a dose higher than 0.2 mg/kg/day (and/or 0.4 mg/kg/48h) was found to be the major determinant on the growth pattern of nephrotic children. In conclusion, high-dose prednisolone therapy should be administered no more than 6 months per year if normal growth and adult height are desired.