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Bone mineral density and its influencing factors in children with idiopathic nephrotic syndrome: a prospective

Indar K Sharawat1, Lesa Dawman1, Merabhai V Kumkhaniya1

  • 1Junior Resident, Department of Pediatrics, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.

Tropical Doctor
|August 14, 2019
PubMed

Insights

Children with idiopathic nephrotic syndrome (INS) treated with glucocorticoids face risks to bone health. Low vitamin D levels, not steroid dose, were found to be the primary predictor of reduced bone mineral density in these patients.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Idiopathic nephrotic syndrome (INS) in children is primarily treated with glucocorticoids.
  • Glucocorticoid therapy can lead to adverse effects on bone metabolism, including decreased bone mineral density (BMD).
  • Children with INS are at increased risk for skeletal complications due to the disease and its treatment.

Purpose of the Study:

  • To investigate the factors influencing bone mineral density (BMD) in children with idiopathic nephrotic syndrome (INS).
  • To identify predictors of low bone mineral density (BMD) in pediatric patients undergoing glucocorticoid therapy for INS.

Main Methods:

  • A cohort of 60 children diagnosed with INS was studied.
  • Patients were categorized into two groups based on relapse frequency and steroid dependency.
  • Bone mineral density (BMD) of the lumbar spine was assessed using dual-energy X-ray absorptiometry (DXA).

Main Results:

  • Mean BMD Z-scores were compared between the patient groups.
  • Univariate analysis revealed significant correlations between BMD Z-scores and cumulative steroid dose, serum vitamin D levels, and calcium supplementation.
  • Multivariate analysis identified serum vitamin D level as the sole significant predictor of low BMD Z-scores.

Conclusions:

  • Serum vitamin D levels are a critical factor in maintaining bone mineral density (BMD) in children with idiopathic nephrotic syndrome (INS).
  • Monitoring and optimizing vitamin D status may be crucial for preventing low bone mineral density (BMD) in pediatric INS patients.
  • Further research into targeted supplementation strategies is warranted.

Keywords:
Bone mineral diseasedual-energy X-ray absorptiometryglucocorticoidsnephrotic syndromeosteopeniaosteoporosis

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