Growth and endocrine function in steroid sensitive nephrotic syndrome.

Area of Science:

• Pediatric Endocrinology
• Nephrology
• Growth and Development

Background:

• Steroid-sensitive nephrotic syndrome (SSNS) is a common kidney disease in children.
• Long-term corticosteroid therapy is the mainstay treatment for SSNS, but can cause significant side effects.
• Growth impairment and delayed puberty are known complications of prolonged steroid use in children.

Purpose of the Study:

• To assess the impact of long-term steroid treatment on physical growth and endocrine function in children with SSNS.
• To identify factors influencing growth retardation in this patient population.

Main Methods:

• Longitudinal assessment of height standard deviation score (Ht SDS) in 29 boys and 12 girls with SSNS.
• Correlation analysis of growth changes (delta Ht SDS) with age, treatment duration, relapse rate, and cyclophosphamide use.
• Endocrinological evaluation (overnight hormone profile) in eight adolescent boys.

Main Results:

• Growth (delta Ht SDS) significantly worsened with age in both genders.
• A negative correlation between delta Ht SDS and treatment duration was observed in boys.
• Boys over 10 years old showed significant Ht SDS decrease, linked to delayed secondary sexual characteristics.
• Six of eight adolescent boys exhibited blunted growth hormone and gonadotropin pulsatility.
• Abnormal endocrine function correlated with delayed puberty and severe growth retardation in boys.

Conclusions:

• Long-term steroid treatment for SSNS adversely affects growth in children, particularly boys.
• Endocrine dysfunction, manifesting as blunted hormone secretion and delayed puberty, is a key factor in steroid-induced growth retardation.
• Monitoring endocrine function and growth is crucial in children receiving prolonged steroid therapy for SSNS.