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

Background: Children with nephrotic syndrome may be at risk for metabolic bone disease because of biochemical derangement caused by renal disease as well as steroid therapy. Objectives: The aim of the work was to evaluate linear growth and bone turnover markers (Calcium, Phosphorus, Alkaline phosphatase and Osteocalcin) in nephrotic syndrome patients specially SDNS{u2215}FRNS and SRNS patients in comparison to a matched control group. Methods: The study is a cross sectional case-control study that included 30 patients with SDNS{u2215}FRNS and 30 SRNS patients aged 2-15 years matched with 28 healthy control children. Both patients and controls was subjected to clinical examination and we measured serum calcium, phosphorus, alkaline phosphatase and osteocalcin). Results: Height of both SDNS{u2215}FRNS and SRNS showed lower height for age percentile compared to control group (p=0.017 and 0.00 respectively). Also height of all NS patients were negatively correlated to duration of steroid, cyclophosphamide (CYP) and cyclosporine therapy (p= 0.05, p= 0.044 and 0.02 respectively).Lower serum calcium levels were (mean 8.9±0.8) mg/dL and significant lower calcium levels in all NS patients compared to the control group (P=0.0001). Higher ALP levels in both SDNS{u2215}FRNS and SRNS patients compared to control group but with statistical significance for only SRNS patients (p= 0.02). Higher Serum osteocalcin levels in both SDNS{u2215}FRNS and SRNS patients groups compared to the control group (P=0.02 and 0.01 respectively). We also found that osteocalcin levels were negatively correlated to serum calcium levels of our patients (p-value = 0.0001). Conclusion: Glucocorticoids therapy of NS patients especially on long term treatment in SDNS{u2215}FRNS and SRNS patients affects the height of patients and some markers of bone metabolism in the form of decrease serum Calcium level and increase serum alkaline phosphatase and osteocalcin level

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