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Effect of prednisone on growth and bone mineral content in childhood glomerular disease
Insights
Prednisone treatment in children with glomerular disease significantly impacts bone health and growth. Alternate-day prednisone therapy, not the disease itself, appears to reduce bone mineral content and slow height velocity.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Glomerular diseases in children can affect growth and bone health.
- Corticosteroid therapy is often used but may have adverse effects.
Purpose of the Study:
- To evaluate the effects of prednisone on bone mineral content (BMC), bone density, and height in children with acquired glomerular disease.
- To compare outcomes between children treated with prednisone and those not receiving corticosteroids.
Main Methods:
- Two groups of children with glomerular disease were studied: one receiving prednisone (daily or alternate-day) and one not receiving corticosteroids.
- Bone mineral content (BMC) and bone density were measured using photon absorption technique.
- Height and height velocity were compared to 800 sex- and age-matched controls.
Main Results:
- Prednisone-treated children showed significant demineralization (18/25) compared to the non-treated group (0/17).
- Prednisone group was significantly shorter (5.3% vs 1.9%) and had reduced height velocity (2.6 cm/yr vs 5.1 cm/yr) compared to controls.
- Discontinuation of prednisone led to improvements in height and BMC.
Conclusions:
- Alternate-day prednisone therapy, not glomerular disease, significantly influences bone mineral content and height velocity in children.
- Monitoring bone health is crucial in pediatric patients undergoing corticosteroid treatment.
Abstract:
Children with acquired glomerular disease were divided into two groups: Group 1 patients received short-term daily or long-term alternate-day prednisone (up to 2.7 mg/kg/48 hr); group 2 patients received no corticosteroids. Height, bone mineral content (BMC), and bone density were evaluated in the two groups and compared to those of 800 sex- and age-matched controls; BMC and bone density were assessed by the photon absorption technique. Significant demineralization was present in 18 of 25 prednisone-treated and none of the 17 nonprednisone-treated patients (P less than .001). Group 1 patients were 5.3 +/- 0.7% shorter than controls, while group 2 patients were only 1.9 +/- .8% shorter (P less than .02). Height velocity was 2.6 +/- 0.8 cm/yr in group 1 and 5.1 +/- 0.8 cm/yr in group 2 patients (P less than .05). When prednisone therapy was discontinued, six patients had an increase in height and BMC toward normal values. This study suggests that BMC and height velocity are correlated. Both appear to be influenced by alternate-day prednisone therapy rather than by glomerular disease per se.