Early and frequent development of ocular hypertension in children with nephrotic syndrome

Kawaguchi, Emi; Ishikura, Kenji; Hamada, Riku; Nagaoka, Yoshinobu; Morikawa, Yoshihiko; Sakai, Tomoyuki; Hamasaki, Yuko; Hataya, Hiroshi; Noda, Eiichiro; Miura, Masaru; Ashihara, Takashi; Honda, Masashi

doi:10.1007/s00467-014-2848-x

“…19 However, another study in Japan found a higher prevalence of IOP (30.8%). 20 The retrospective cohort design of the Japan study, in contrast to our cross-sectional design, may have contributed to the higher prevalence. Studies on IOP in nephrotic children on long-term steroid therapy have been limited worldwide.…”

Section: Discussionmentioning

confidence: 83%

Ocular complications in pediatric nephrotic syndrome treated with corticosteroids

L. Toruan,

Trihono,

Sitorus

et al. 2024

PI

0

View full text Add to dashboard Cite

Background Posterior subcapsular cataracts (PSC) and raised intraocular pressure (IOP) are the most common ocular complications of oral steroid administration, particularly following long-term use or treatment with high doses. Objective To evaluate the association between cumulative steroid dose and duration of treatment with the occurrence of PSC and raised IOP, as well as its associated factors in children with idiopatic nephrotic syndrome (INS). Methods This cross-sectional study included children aged 4–18 years with INS who received oral steroid therapy for at least six consecutive months. Patients underwent complete eye examinations by an ophthalmologist to evaluate their visual acuity as well as the occurrence of PSC and/or raised IOP. Results Of 92 subjects, 19.6% had PSC, 12% had raised IOP, and one had a best corrected visual acuity (BCVA) of <6/20. The median cumulative steroid dose was 12,161 (range 1,795–81,398) mg and median treatment duration was 23 (range 6–84) months. There were significant positive associations between cumulative steroid dose as well as treatment duration and the occurrence of PSC, with cut-off points of 11,475 mg and 24 months, respectively, as determined by receiver operator characteristic (ROC) curves. Females were four times more likely to have PSC compared to males (PR 4; 95%CI 1.57 to 13.38; P=0.001). Cumulative steroid dose and duration of treatment were not associated with raised IOP. Conclusion Cumulative steroid dose of 11,475 mg or higher and/or duration of steroid therapy of 24 months of more were significantly associated with the occurrence of PSC, but not with raised IOP.

show abstract

“…Out of 12, nine studies are observational. Out of nine, two are retrospective cohort studies [30,33], five are prospective cohort studies [31,32,34,35,36], and one is both a retrospective and prospective cohort study [37]. Three studies out of 12 are case reports [27,28,29], and one is cross-sectional [26].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All included studies show prolonged steroid use followed by significantly high IOP/OHT development. The following studies also compared the dosage and duration of steroid use with IOP rise to see if any significant association exists between them [26,27,30,31,32,33,36,37]. The specific duration during treatment with steroids after which changes in IOP were detected is also discussed.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Association Between the Use of Systemic Steroids and Ocular Hypertension as a Side Effect in Pediatric Population: A Systematic Review

Mushtaq,

Shaman Ameen,

Nie

et al. 2023

Cureus

3

0

View full text Add to dashboard Cite

Steroids are commonly used in children for the treatment of various medical conditions. However, systemic steroids can lead to the development of ocular hypertension (OHT), an increase in intraocular pressure. Limited literature is available on the systemic route of steroid administration in children and the development of this side effect. For literature writing and review, a thorough research was conducted across various platforms, such as PubMed, PubMed Central (PMC), Medline, and Cochrane Database of Systematic Reviews (CDSR). After all the screening processes and quality checks, 12 articles were finalized for review writing. The aim was to explore if OHT development is a common side effect developed in children on systemic steroid use for various medical conditions and if any particular risk factors were present among children that lead to its development. The results indicate that OHT is a common side effect of systemic steroid use in children. Children may or may not present with the symptoms of raised intraocular pressure. The development of OHT occurs within one month of the beginning of the steroid treatment in most of the reviewed studies. Several risk factors associated with developing this side effect were also found. In conclusion, systemic steroid use in children leads to the development of OHT. Awareness among healthcare professionals regarding this potential association is necessary. This information can be used to develop guidelines for serial ocular examinations in children on prolonged systemic steroid use.

show abstract

“…(ii) Improvement: except for the occasional small amount of proteinuria, other indicators were normal for more than 3 years. (iii) Invalid: urine protein was still +++ (or higher) or death [15].…”

Section: Efficacy Evaluation Criteriamentioning

confidence: 99%

Study of the Therapeutic Effects of Chinese Herbal Decoction Combined with Glucocorticoid in Treating Primary Nephrotic Syndrome in Children

Hou

¹

,

Xu

²

,

Li

³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Background. To investigate the clinical effects of Chinese medicine decoction combined with glucocorticoid in treating children with primary nephrotic syndrome. Methods. A total of 70 children with pediatric nephritis nephrotic syndrome treated at Weifang People’s Hospital from January 2019 to December 2019 were randomly allocated to the therapy group and the control group, each with 35 cases. The control group was treated with conventional Western medicine, and the therapy group received Western medicine and Chinese medicine. After 12 weeks of treatment, the therapeutic effect of the two groups was compared. Results. After receiving the treatment, the levels of urine protein (UPro), triglyceride, and cholesterol were significantly decreased in the two groups ( p < 0.05 ), and these levels in the therapy group were much lower than those of the control group ( p < 0.05 ). However, the level of albumin (ALB) was predominantly increased in the two groups after treatment ( p < 0.05 ), and this level in the therapy group was much higher than that of the control group ( p < 0.05 ). Moreover, the immune indicators, coagulation function, and recurrence rate were noticeably improved after treatment ( p < 0.05 ), and the therapy group was better than the control group ( p < 0.05 ). Furthermore, the comparison of renal function indexes, liver function indexes, and blood routine between the two groups showed no statistical significance in the incidence of adverse reactions between the two groups ( p > 0.05 ). Conclusions. For the treatment of refractory nephrotic syndrome in children, based on conventional shock therapy, the addition of traditional Chinese medicine (Liuwei Dihuang pill decoction) remedy can significantly improve the disease symptoms in children and improve the efficacy, and the incidence of adverse reactions is low.

show abstract

Early and frequent development of ocular hypertension in children with nephrotic syndrome

Abstract: Routine ophthalmologic examination should be conducted from the early phase after the start of prednisolone treatment. In addition, children with episodes of ocular hypertension may be at greater risk of its reappearance with relapse of the nephrotic syndrome.

Cited by 11 publications

References 20 publications

Ocular complications in pediatric nephrotic syndrome treated with corticosteroids

Ocular complications in pediatric nephrotic syndrome treated with corticosteroids

Association Between the Use of Systemic Steroids and Ocular Hypertension as a Side Effect in Pediatric Population: A Systematic Review

Study of the Therapeutic Effects of Chinese Herbal Decoction Combined with Glucocorticoid in Treating Primary Nephrotic Syndrome in Children

Contact Info

Product

Resources

About