K R Mohan1, M Kanitkar2. 1. Graded Specialist (Pediatrics), MH Allahabad, UP:-211001. 2. Professor & Head (Department of Pediatrics), Armed Forces Medical College, Pune- 411040.
Abstract
BACKGROUND: Nephrotic syndrome in children usually has an onset between 2-8 years of age and steroids form the mainstay of management. Therapy may affect growth in children with relapsing nephrotic syndrome. This study was carried out to correlate growth with the cumulative dose of steroids in children with steroid sensitive nephrotic syndrome (SSNS). METHODS: Data of 35 children with SSNS was analysed retrospectively. They were divided into two groups. Group I received prednisolone only and Group II received levamisole and or cyclophosphamide in addition to steroids. Their heights were recorded at the time of inclusion and again one year later. The SD scores for age were determined. Growth rate as a change in the SD score over one year (Δ SD score) was correlated to the cumulative dose of steroids over the same period using the Pearson's correlation. RESULT: There were 24 (68.6 %) boys and 11 (31.4 %) girls (M:F ratio 2.18:1) in the age group of 17 months to 11 years at inclusion. Group I constituted 19 (54.2 %) and Group II, 16 (45.8 %). Pearson's correlation coefficients for all children, Groups I and II were -0.341, -0.441 and -0.255 respectively indicating "Fair correlation". This indicates that as the cumulative dose of steroid increases the growth retardation becomes more apparent. CONCLUSION: Growth retardation is proportional to the cumulative dose of steroids in children with SSNS.
BACKGROUND:Nephrotic syndrome in children usually has an onset between 2-8 years of age and steroids form the mainstay of management. Therapy may affect growth in children with relapsing nephrotic syndrome. This study was carried out to correlate growth with the cumulative dose of steroids in children with steroid sensitive nephrotic syndrome (SSNS). METHODS: Data of 35 children with SSNS was analysed retrospectively. They were divided into two groups. Group I received prednisolone only and Group II received levamisole and or cyclophosphamide in addition to steroids. Their heights were recorded at the time of inclusion and again one year later. The SD scores for age were determined. Growth rate as a change in the SD score over one year (Δ SD score) was correlated to the cumulative dose of steroids over the same period using the Pearson's correlation. RESULT: There were 24 (68.6 %) boys and 11 (31.4 %) girls (M:F ratio 2.18:1) in the age group of 17 months to 11 years at inclusion. Group I constituted 19 (54.2 %) and Group II, 16 (45.8 %). Pearson's correlation coefficients for all children, Groups I and II were -0.341, -0.441 and -0.255 respectively indicating "Fair correlation". This indicates that as the cumulative dose of steroid increases the growth retardation becomes more apparent. CONCLUSION:Growth retardation is proportional to the cumulative dose of steroids in children with SSNS.
Authors: L Rees; S A Greene; P Adlard; J Jones; G B Haycock; S P Rigden; M Preece; C Chantler Journal: Arch Dis Child Date: 1988-05 Impact factor: 3.791