Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Nephrotic syndrome (NS) is a common glomerular disease in children & steroid therapy remains the standard therapy for this disease. Noninvasive measures of diagnosing steroid resistant NS (SRNS) are lacking. The aim of this study is to evaluate the role of urinary vitamin D binding protein (u VDBP) as a predictor of steroid response & to identify other variables associated with steroid resistance in NS. Methods: This is a prospective longitudinal study that included 60 children with active NS & 30 control subjects as reference for u VDBP values. NS patients were tested for u VDBP at presentation & follow up assessment of their response to steroids was done 4-8 weeks later. Results: levels of u VDBP are elevated in NS patients than controls (33.33±15.6 versus 17.35±5.5 ng/ml, p=0.001) with further elevation in relapsing than patients with first presentation NS (37.93±16.2 versus 28.73 ±13.67 ng/ml, p= 0.014). No significant difference was detected in u VDPB levels at presentation & steroid response 4-8 weeks later (34.91±15.01ng/ml in SSNS versus 32.60±15.94 ng/ml in SRNS, p= 0.417). Steroid resistance was significantly associated with younger age of onset, longer duration of illness, relapses, increased total leucocyte and platelet counts (p= 0.023, 0.007, 0.002, 0.031& 0.044 respectively)

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