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Effects of Steroid Treatment on Bone Mineral Metabolism in Children with Glucocorticoid-sensitive Nephrotic Syndrome

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Glucocorticoids have been used in nephrotic syndrome (NS) treatment for many years. In this study, we aimed to evaluate the effect of steroids on bone mineralization in children with glucocorticoid-sensitive nephrotic syndrome (GSNS).
Twenty children who were first diagnosed as GSNS received glucocorticoid therapy for four months. Before treatment, at the 4th and 12th week of initial therapy, bone mineral density (BMD) and levels of the markers for bone turnover were evaluated.
At the 4th and 12th week of treatment, mean serum calcium (Ca) and osteocalcin levels were found to be significantly lower than those at the beginning of the therapy. Mean serum total alkaline phosphatase (t-ALP), bone-specific alkaline phosphatase (b-ALP) and urine calcium creatinine ratio (Ca/Cr), urinary deoxypyridinoline levels were significantly increased in comparison to the beginning of therapy.
There was no significant relationship between serum levels of phosphate and parathyroid hormone (PTH) at the beginning of treatment and at the 4th and 12th week of treatment. Mean value of BMD was significantly lower at the 4th and 12th week of treatment than that at the beginning of the therapy.
In conclusion, bone mineralization was negatively affected by steroid treatment in children with NS. These children should undergo regular BMD evaluation, and an appropriate therapeutic approach should be planned.

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e-Published: 24 Jan, 2013
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