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Normal growth of prepubertal nephrotic children during long-term treatment with repeated courses of prednisone

M T Saha1, P Laippala, H L Lenko

  • 1Department of Paediatrics, Medical School, Tampere University, Tampere University Hospital, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|June 26, 1998
PubMed

Insights

Children with frequently relapsing nephrotic syndrome experienced normal growth despite long-term oral prednisone treatment. This study tracked height and growth velocity in 21 prepubertal children over four years.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth and Development

Background:

  • Steroid-dependent frequently relapsing nephrotic syndrome (SRNS) is a chronic kidney condition in children.
  • Long-term corticosteroid use, such as prednisone, raises concerns about growth inhibition in pediatric patients.
  • Monitoring growth is crucial for managing children with SRNS undergoing treatment.

Purpose of the Study:

  • To evaluate the impact of repeated oral prednisone courses on the growth of prepubertal children with SRNS.
  • To assess longitudinal changes in height and height velocity during a 4-year treatment period.
  • To determine if prednisone treatment affects overall growth in children with this condition.

Main Methods:

  • Longitudinal study of 21 prepubertal children with SRNS over 4 years.
  • Measurement of height and calculation of height standard deviation scores (HSDS) and height velocity standard deviation scores (HVSDS) annually.
  • Calculation of mean yearly cumulative doses of oral prednisone (mg/m²).

Main Results:

  • Children exhibited normal HSDS and HVSDS before disease onset (-0.11 and -0.06).
  • Growth parameters remained within normal ranges throughout the 4-year prednisone treatment, with HVSDS showing improvement over time (+0.05 to +0.66).
  • Mean cumulative prednisone doses decreased annually, indicating potential for dose reduction strategies.

Conclusions:

  • Oral prednisone treatment for steroid-dependent frequently relapsing nephrotic syndrome did not impede the growth of prepubertal children in this cohort.
  • Normal growth was maintained despite varying cumulative doses of prednisone over a 4-year period.
  • These findings suggest that careful monitoring and management allow for normal growth in children with SRNS on long-term prednisone therapy.

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