الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Development of low bone mineral density is increasingly
recognized as an important complication of nephrotic syndrome in
patients with prolonged clinical courses. Risk factors include large
cumulative dose of steroid therapy, long duration of treatment by steroid
and older age at onset of the disease .
The current study was done to assess bone mineral density among
children with nephrotic syndrome on long term steroid therapy ( more
than 6 months) .
The children in this study were classified into 2 groups:
group I : 25 patients of idiopathic nephrotic syndrome (3 of them
was in active stage of the disease , 22 of them was in remission)
group II : 25 of apparently heathly children enrolled as control of
the same age group.
All children underwent through history taking, physical
examination and laboratory investigation in the form of complete blood
count,Serum creatinine, BUN, albumin, Na ,K ,liver enzymes (ALT,
AST), Po4 , calcium total and ionized , PTH and alkaline phosphatase .
Only cases were subjected to estimation of bone mineral density
(BMD) through DEXA scan .
In comparison between 2 studied groups regarding BP ( SBP and
DBP), serum calcium (total and ionized), phosphorus, alkaline
phosphatase and PTH level statistically significant difference was
present between group I (Nephrotic group) and group II(Control
group).While no significant difference regarding demographic data,
laboratory data that include (CBC parameters , Serum creatinine, BUN,
albumin, Na ,K and liver enzymes (ALT,AST)).
Regarding measurement of BMD among cases there were ( 2 of
25) 8% osteoporotic, (11 of 25) 44% osteopenic and (14 of 25) 48%
within average range of BMD .
Regarding correlation between Z score and drugs received there
was a significant positive correlation between Z score and ( steroid
duration and steroid cumulative dose) , and negative correlation between
Z score and immunosuppressive drugs.
Regarding study of multivariant factors affecting BMD there was
the steroid cummulative dose was only significant independent risk
factor and age , BMI ,SBP, steroid duration were non significant
independent risk factors.
We concluded that:
Steroid therapy in large cumulative dose and longer duration can
lead to decrease in BMD and increase risk of fracture even without
evident clinical manifestation to that.
We recommended that:
Regular BMD evaluation and appropriate therapeutic interventions
are recommended for these children.
The role of prophylactic therapy in such patients needs to be
further evaluated.