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Bone densitometry in children with idiopathic nephrotic syndrome on prolonged steroid therapy: A tertiary multicenter

Ahmed S A Soliman1, Mohamed W Abukhatwah2, Naglaa M Kamal3

  • 1Pediatric department, faculty of medicine, Benha University, Benha, Egypt.

Medicine
|August 19, 2022
PubMed

Insights

Children with idiopathic nephrotic syndrome (INS) on long-term steroid therapy show significantly lower bone mineral density (BMD). This steroid use leads to a high prevalence of osteopenia and osteoporosis in pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Bone Metabolism
  • Nephrology

Background:

  • Long-term glucocorticoid (steroid) use impairs bone mineralization and strength.
  • Steroids are known to cause osteoporosis, negatively impacting bone mineral content (BMC) and bone mineral density (BMD).
  • Idiopathic nephrotic syndrome (INS) in children often requires corticosteroid treatment.

Purpose of the Study:

  • To assess the bone mineral density (BMD) in children diagnosed with idiopathic nephrotic syndrome (INS) undergoing corticosteroid therapy.
  • To compare BMD in pediatric INS patients on steroids with a healthy control group.

Main Methods:

  • A cross-sectional study involving 90 pediatric patients with INS on corticosteroids and 50 healthy controls.
  • Bone mineral density (BMD) measurement at the lumbar spine (L2-L4) using Dual-energy X-ray absorptiometry (DEXA).
  • Assessment of renal function, bone biochemistry, and parathyroid hormone (PTH) levels in both groups.

Main Results:

  • Patients exhibited significantly higher serum PTH, phosphorous, and alkaline phosphatase levels.
  • A statistically significant reduction in blood calcium levels was observed in INS patients.
  • DEXA scans revealed osteopenia in 26.7% and osteoporosis in 13.3% of INS patients, with significantly lower BMD, BMD-z scores, and BMC compared to controls.

Conclusions:

  • Pediatric patients with INS receiving corticosteroid treatment demonstrate reduced bone mineral density (BMD).
  • There is a high prevalence of osteopenia and osteoporosis in this patient group, as indicated by DEXA scans.
  • Corticosteroid therapy has a detrimental effect on bone mineralization in children with INS.

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