ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
The growth effects of long-term (five years) prednisone therapy in frequently relapsing nephrotic syndrome of childhood: impact on statural growth and weight gain
Ashraf Soliman 1 , Noor Hamed 1 , Mostafa Elbaba 1 , Fawzia Alyafei 1 , Maya Itani 2 , Fatima Al-Naimi 2 , Doaa Al Yousef 2 & Mona Shaat Dalees 2
1Hamad Medical Center, Pediatrics, Doha, Qatar; 2Hamad Medical Center, Nutrition and Dietitic Department, Doha, Qatar
Nephrotic syndrome (NS) 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 NS.
Aim: This study was carried out to investigate linear growth and weigh gain in children with NS and multiple relapses who receiving long-term prednisone therapy (LTPT) for 5 years.
Methods: Data of 30 children with SSNS was analysed retrospectively. They received prednisolone only in the standard dose for the initial episode at 2 mg/kg/day for six weeks followed by 1.5 mg/kg on alternate days for six weeks and relapses were treated with 2 mg/kg/day till remission followed by 1.5 mg/kg/day for four weeks. (height, HtSDS, weight, BMI and BMISDS) were recorded each clinic visit along the treatment period. Growth data were correlated with the cumulative dose of steroid.
Results: The mean cumulative prednisone = 125+/- 28 mg /kg/yr given over an average duration of 5 years. The HtSDS was not affected after 3 years (from -0.38 to -0.35 respectively) but decreased to -0.79 after 5 years ( -0.4 SD loss). The BMISDS increased from 0.65 to 0.97 and 1.1 after 3 and 5 years respectively. Obesity (OB) and overweight (OW) increased from 25% pre-treatment to 59.2% after 5 years of treatment. Hypertension was detected in 12.5% and 23% of patients after 3 and 5 years of treatment.
| Age | WT | WTSD | HT | HTSD | BMI | BMISD | |
| years | kg | cm | kg/m2 | ||||
| Mean | 3.99 | 17.66 | 0.19 | 102.17 | -0.38 | 16.67 | 0.65 |
| SD | 2.19 | 6.40 | 0.77 | 16.35 | 1.09 | 1.34 | 0.90 |
| Mean | 6.72 | 26.97 | 0.70 | 118.98 | -0.35 | 18.29 | 0.97 |
| SD | 2.50 | 11.77 | 1.37 | 15.16 | 1.02 | 4.22 | 1.51 |
| Mean | 8.93 | 34.88 | 0.42 | 126.91 | -0.79 | 19.98 | 1.10 |
| SD | 3.85 | 21.30 | 1.28 | 21.44 | 1.21 | 5.68 | 1.28 |
| Beginning | After 3 yr. | After 5 yr. | |
| BMISDS > 2 | 2/32 | 7/32 | 8/32 |
| % Obesity (OB) | 6.25% | 21.88% | 25.00% |
| BMISDS >1<2 (OW) | 6/32 | 7/32 | 10/32 |
| % OB | 18.75% | 21.88% | 31.25% |
| Total OB and OW | 8/32 | 14/32 | 18/32 |
| 25.00% | 43.75% | 56.25% |
Conclusion: Long term prednisone therapy (for 5 years) with a mean cumulative dose of prednisone = 125 +/- 28 mg/kg/yr. was associated with a small decrease in the HtSDS but significant increase in the BMISDS, OW, obesity and hypertension.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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