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Body weight changes in children with idiopathic nephrotic syndrome
Elżbieta Kuźma-Mroczkowska1, Małgorzata Pańczyk-Tomaszewska1, Piotr Skrzypczyk2
1Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland.
Insights
Glucocorticoid (GC) therapy for idiopathic nephrotic syndrome (INS) in children can lead to weight gain. Risk factors include low initial BMI, older maternal age, and paternal obesity.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Metabolic Disorders
Background:
- Idiopathic nephrotic syndrome (INS) is a common kidney disorder in children.
- Glucocorticoids (GC) are the primary treatment for the initial bout of INS.
- Body mass changes during GC therapy require investigation.
Purpose of the Study:
- To evaluate factors influencing body mass changes in children with INS during 6 months of initial GC treatment.
- To identify potential risk factors for weight gain in this pediatric population.
Main Methods:
- A cohort of 31 children with INS and 31 healthy controls were studied over 6 months.
- Evaluated parameters included body mass index (BMI) Z-scores, GC dosage, parental factors, and lifestyle variables.
- Statistical analysis correlated changes in BMI Z-score with various potential influencing factors.
Main Results:
- Children with INS showed a significant increase in BMI Z-score after 6 months of GC therapy (P=0.049).
- The change in BMI Z-score was negatively correlated with the initial BMI Z-score (r=-0.45, P=0.001).
- Increased BMI Z-score changes were associated with older maternal age (r=0.38, P=0.04) and paternal obesity (r=0.51, P=0.0037).
Conclusions:
- Initial 6-month glucocorticoid therapy for idiopathic nephrotic syndrome can lead to increased body mass in children.
- Low initial BMI, advanced maternal age, and paternal obesity are identified as risk factors for body mass increase during early INS treatment.
Background:
Aim of the study was to evaluate factors affecting body mass change in children with idiopathic nephrotic syndrome (INS) during 6-months treatment of initial disease bout with glucocorticoids (GC).
Material And Methods:
We studied 31 children with INS (22♂, 9♀, 3.6±1.8 years) treated during 6 months with GC due to initial INS bout and 31 control healthy children (18♂, 13♀, 4.0±1.8 years). Following factors were evaluated: body mass, body mass index (BMI), BMI Z-score, gender, age, gestational age at birth, birth weight, GC dose, parental age and BMI, time spent for TV/computer, physical activity, place of residence.
Results:
Mean initial BMI Z-score was 0.35±1.1 in children with INS and -0.11±1.5 in the control group, after 6 months 0.8±1.2 (P=0.049) and 0.07±1.5 (P=0.629), respectively. Δ0-6 BMI Z-score correlated with initial BMI Z-score (r=-0.45, P=0.001), maternal age (r=0.38, P=0.04), and paternal BMI (r=0.51, P=0.0037).
Conclusions:
1. Initial 6-month GC therapy may result in body mass increase in children with INS. 2. Risk factors for body mass increase in children with INS during the first 6 months of therapy include low initial BMI, older maternal age and paternal obesity.
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