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Growth in steroid-responsive nephrotic syndrome: a study of 85 pediatric patients

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Abstract

The statural growth of 85 patients with steroid-responsive idiopathic nephrotic syndrome, attending the Pediatric Nephrology Unit, Children's Institute, Hospital das Clínicas School of Medicine, University of São Paulo, with a minimum follow-up of 3 years, was evaluated. Analysis of the patient population as a group did not show any significant alterations in the height Z score and the mean height percentile between the first (−0.59 and 33.9, respectively) and last consultation (−0.57 and 34.8, respectively). Analysis of each individual patient allowed the definition of two subgroups. Subgroup A, which achieved growth improvement, was composed of 47 children—initial Z score and mean initial height percentile of –0.91 and 24.0, respectively; final Z score and mean height percentile of –0.30 and 40.7, respectively (P=0.00). Subgroup B, which showed growth retardation, was composed of 38 children—initial Z score and mean initial height percentile of –0.19 and 46.2, respectively; final Z score and mean height percentile of −0,9 and 27.5, respectively (P=0.00). The following factors were significantly different when both subgroups were compared: (1) total duration of prednisone therapy and total prednisone dose were greater in subgroup B; (2) the final chronological age of patients using prednisone was higher in subgroup B; (3) the pubertal growth spurt in subgroup B showed attenuation and retardation.

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References

  1. Grymonprez A, Proesmans W, Van Dyck M, Jans I, Goos G, Bouillon R (1995) Vitamin D metabolites in childhood nephrotic syndrome. Pediatr Nephrol 9:278–281

    CAS  PubMed  Google Scholar 

  2. Ito S, Kano K, Ando T, Ichimura T (1994) Thyroid function in children with nephrotic syndrome. Pediatr Nephrol 8:412–415

    CAS  PubMed  Google Scholar 

  3. Lee DY, Park SK, Kim JS (1996) Insulin-like growth factor-I (IGF-I) and IGF-binding proteins in children with childhood nephrotic syndrome. J Clin Endocrinol Metab 81:1856–1860

    CAS  PubMed  Google Scholar 

  4. Scharer K, Essigmann HC, Schaefer F (1999) Body growth of children with steroid-resistant nephrotic syndrome. Pediatr Nephrol 13:828–834

    Article  CAS  PubMed  Google Scholar 

  5. Binz K, Schmid C, Bouillon R, Froesch RE, Jürgensen K, Hunziker EB (1994) Interactions of insulin-like growth factor I with dexamethasone on trabecular bone density and mineral metabolism in rats. Eur J Endocrinol 130:387–393

    CAS  PubMed  Google Scholar 

  6. Lettgen B, Jeken C, Reiners C (1994) Influence of steroid medication on bone mineral density in children with nephrotic syndrome. Pediatr Nephrol 8:667–670

    CAS  PubMed  Google Scholar 

  7. Sanchez CP, Goodmann WG, Brandli D, Goldenhersh M, Murray C, Carlton E, Hahn T, Salusky IS (1995) Skeletal response to recombinant human growth hormone (rhGH) in children treated with long-term corticosteroids. J Bone Miner Res 10:2–6

    CAS  PubMed  Google Scholar 

  8. Wade CE, Lindberg JS, Cockrell JL, Lamiell JM, Hunt MM, Ducey J, Jurney TH (1988) Upon-admission adrenal steroidogenesis is adapted to the degree of illness in intensive care unit patients. J Clin Endocrinol Metab 67:223–227

    CAS  PubMed  Google Scholar 

  9. Luo J, Murphy LJ (1989) Dexamethasone inhibits growth hormone induction of insulin-like growth factor (IGF-I) messenger ribonucleic acid levels (mRNA) in hypophysectomized rats and reduces RNA m-IGF-I abundance in the intact rat. Endocrinology 125:165–171

    CAS  PubMed  Google Scholar 

  10. Soliman AT, Madina EH, Abdel-Fattah M, El Zalanany M, Asfour M, Morsi MR (1995) Nocturnal growth hormone (GH) secretion and response to clonidine provocation in children before and after long-term prednisone therapy. J Trop Pediatr 41:344–347

    CAS  PubMed  Google Scholar 

  11. Polito C, Oporto MR, Totino SF, La Manna A (1986) Normal growth of nephrotic children during long-term alternate-day prednisone therapy. Acta Paediatr Scand 75:245–250

    CAS  PubMed  Google Scholar 

  12. Rees L, Greene SA, Adlard P, Jones J, Haycock GB, Rigden SPA, Preece M, Chantler C (1988) Growth and endocrine function in steroid sensitive nephrotic syndrome. Arch Dis Child 63:484–490

    CAS  PubMed  Google Scholar 

  13. Polito C, Di-Toro R (1992) Delayed pubertal growth spurt in glomerulopathic boys receiving alternate-day prednisone. Child Nephrol Urol 12:202–207

    CAS  PubMed  Google Scholar 

  14. Matsukura H, Inaba S, Shinozaki K, Yanagihara T, Hara M, Higuchi A, Yakada T, Tanizawa T, Miyawaki T (2001) Influence of prolonged corticosteroid therapy on the outcome of steroid-responsive nephrotic syndrome. Am J Nephrol 21:362–367

    Article  CAS  PubMed  Google Scholar 

  15. International Study Of Kidney Disease In Children (ISKDC) (1978) Nephrotic syndrome in children: prediction of histopathology from clinical and laboratory characteristics time of diagnosis. Kidney Int 13:159–165

    PubMed  Google Scholar 

  16. International Study Of Kidney Disease in Children (ISKDC) (1981) The primary nephrotic syndrome in children: identification of patients with minimal change nephrotic syndrome from initial response to prednisone. J Pediatr 98:561–564

    PubMed  Google Scholar 

  17. Hamil PVV, Drizd TA, Johnson CL, Reed R, Roche AF, Moore WM (1979) Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr 32:607–629

    CAS  PubMed  Google Scholar 

  18. Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 51:170–179

    CAS  PubMed  Google Scholar 

  19. Bagga A, Hari P, Srivastava RN (1999) Prolonged versus standard prednisolone therapy for initial episode of nephrotic syndrome. Pediatr Nephrol 13:824–827

    Article  CAS  PubMed  Google Scholar 

  20. Takeda A, Ohgushi H, Niimura F, Matsutani H (1998) Long-term effects of immunosuppressants in steroid-dependent nephrotic syndrome. Pediatr Nephrol 12:746–750

    CAS  PubMed  Google Scholar 

  21. Hogg RJ, Portman RJ, Milliner D, Lemley KV, Eddy A, Ingelfinger J (2000) Evaluation and management of proteinuria and nephrotic syndrome in children: recommendations from a Pediatric Nephrology panel established at the National Kidney Foundation conference on proteinuria, albuminuria, risk assessment, detection and elimination (PARADE). Pediatrics 105:1242–1249

    CAS  PubMed  Google Scholar 

  22. Rosner B (1995) Fundamentals of biostatistics, 4th edn. Duxbury, New York

  23. Sichieri R, Allam VLC (1996) Assessment of nutritional status of Brazilian adolescents by body mass index. J Pediatr 72:80–84

    Google Scholar 

  24. Must A, Dallal GE, Dietz WH (1991) Reference data for obesity: 85th and 95th percentiles of body mass index (Wt/Ht2) and triceps skinfold thickness. Am J Clin Nutr 53:839–846

    CAS  PubMed  Google Scholar 

  25. Saha MT, Laippala P, Lenko Hl (1998) Normal growth of prepubertal nephrotic children during long-term treatment with repeated courses of prednisone. Acta Paediatr 87:545–548

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pediatric Nephrology Unit, Children's Institute, Hospital das Clínicas School of Medicine, University of São Paulo, São Paulo, Brazil

    Teresinha L. Donatti, Vera H. Koch, Maria D. Fujimura & Yassuhiko Okay

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  1. Teresinha L. Donatti
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  2. Vera H. Koch
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  3. Maria D. Fujimura
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  4. Yassuhiko Okay
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Correspondence to Vera H. Koch.

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Donatti, T.L., Koch, V.H., Fujimura, M.D. et al. Growth in steroid-responsive nephrotic syndrome: a study of 85 pediatric patients. Pediatr Nephrol 18, 789–795 (2003). https://doi.org/10.1007/s00467-003-1142-0

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  • DOI: https://doi.org/10.1007/s00467-003-1142-0

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