[Evaluation of bone mineral turnover in children with nephrotic syndrome--the implications of original disease and the effects of corticosteroids on bone metabolism].
A long term corticosteroids (CS) treatment is often required for children with nephrotic syndrome (NS), which may affect their bone metabolism. In this study we evaluate the effects of CS, and also the implication of the character of NS itself on bones. We divided sixteen cases of idiopathic NS in children into two groups, such as CS responder group (R; male/female = 8/4, mean age 10.9 years old), and CS non-responder group (NR; male/female = 4/0, mean age 10.2 years old). We measured the bone mineral density of lumber vertebrae by quantitative computed tomography (QCT), some biochemical and endocrinological markers for about half a year. The bone mineral density was significantly decreased soon after the beginning of CS therapy. A significant decrease in the serum osteocalcin level and a slight tendency for an increase in urinary excretion of the free hydroxyproline in the both R and NR groups. In addition, NR group showed hypocalcemia, a decrease in the serum 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3, and a slight tendency for an increase in the C-parathyroid hormone and highly sensitive parathyroid hormone levels. In conclusion, the results suggested that the effects of CS on bone metabolism were mainly the suppression of bone formation. In addition, the effects of CS and the character of NS itself should be evaluated separately when we consider about bone metabolism in children with NS and in greater detail.
Department of Pediatric Nephrology, Tokyo Women's Medical College, Japan.
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Takeda
D000284:Administration, Oral; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000378:metabolism*; D011239:Prednisolone / Q000494:pharmacology / Q000627:therapeutic use*
D011239:Prednisolone