Growth and endocrine function in steroid sensitive nephrotic syndrome.

Rees, Lesley; Greene, Stephen A.; Adlard, P; Jones, Janet; Haycock, G B; Rigden, Susan P. A.; Preece, M A; Chantler, C

doi:10.1136/adc.63.5.484

Cited by 89 publications

(63 citation statements)

References 24 publications

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“…In a similar study the growth in both boys and girls, assessed by changes in height standard deviation score (Δ SD scores), worsened significantly with chronological age. There was a significant negative correlation between Δ SD score and duration of treatment in boys but not in girls [5].…”

Section: Discussionmentioning

confidence: 81%

Growth in Children with Steroid Sensitive Nephrotic Syndrome

Mohan

Kanitkar

2009

Medical Journal Armed Forces India

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IntroductionG rowth is an essential feature of childhood. It depends on genetic, nutritional, social and emotional factors. It is affected by chronic systemic disease. Growth follows a sigma shaped curve with a high velocity in the early postnatal period and during puberty, but a steady rate during mid-childhood. Nephrotic syndrome occurs most commonly in the age group of 2-8 years when the growth rate is at a steady state. Patients having frequent relapses and requiring repeated courses of steroids often develop steroid toxicity, including growth retardation [1]. It is known that daily, supraphysiologic doses of glucocorticoids inhibit growth by multiple mechanisms including impaired release of growth hormone and decreased activity of insulin-like growth factor-1 (IGF-1) in growing bones. However their effect in Indian children with steroid sensitive nephrotic syndrome (SSNS) has not been described. This study correlates the growth rate with the cumulative dose of steroids in children with steroid sensitive nephrotic syndrome. Material and MethodsThe data of 35 children with SSNS on regular follow-up for a minimum period of one year at the nephrology clinic of a tertiary level hospital was analyzed retrospectively. These children were divided into two groups. Groups 1 received prednisolone in the standard dose for the initial episode at 2 mg/kg/day for six weeks followed by 1.5mg/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 as per the guidelines of the Indian Academy of Pediatrics [2]. Group II consisted of children who in addition to the steroids had received steroid sparing agents like levamisole and or cyclophosphamide during the year of study.The height was measured using a stadiometer on at least two occasions, first at the time of inclusion in the study and second time a year later. The height was converted into an SD (standard deviation) score (Z score) using the software "CDC EPI Info 2002" which requires age and height for calculation. The change in SD scores over one year was noted as Δ SD score. The cumulative dose of steroids received during the year was calculated for each patient and recorded as mg/kg/year. Correlation of the growth rate as a change in the SD score over one year was done with the cumulative dose of steroids using the Pearson's correlation and its significance noted. Children with steroid resistance or those with a poor follow-up during the study period were excluded from the study. ResultsRecords of 35 children with SSNS were analysed. There were 24 (68.6 %) boys and 11 (31.4 %) girls with the M: F ratio

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Section: Discussionmentioning

confidence: 81%

Growth in Children with Steroid Sensitive Nephrotic Syndrome

Mohan

Kanitkar

2009

Medical Journal Armed Forces India

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“…Rees ve ark. (11) yalnızca erkekler için böyle bir korelasyonun varlığını pubertenin geç başlaması ile (özellikle de sekonder seks karakterlerinin) ilişkilendirmişlerdir. Rees ve ark.…”

Section: Discussionunclassified

Evaluation of the advers effects of the treatment of nephrotic syndrome in children

Esmeray¹,

Emre²,

Yılmaz³

et al. 2017

Cocuk Dergisi

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“…Pacientes em uso prolongado de GC têm queda nos pulsos das gonadotrofinas, e essas alterações se refletem clinicamente em retardo nos caracteres sexuais secundários na adolescência 27 .…”

Section: Glicocorticoides Gonadotrofinas E Puberdadeunclassified

“…O estadiamento puberal deve ser cuidadosamente monitorizado, devido ao risco conhecido de hipogonadismo 27,28 .…”

Section: Puberdadeunclassified

Effects of glucocorticoids on growth and bone mineralization

Donatti¹,

Koch²,

Takayama³

et al. 2011

J Pediatr (Rio J)

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Objective: To review the various mechanisms of glucocorticoid action and the ability of these agents to induce osteoporosis and growth deficits. Sources:A review of the scientific literature was conducted on the basis of a MEDLINE search using the keywords and descriptors "glucocorticoids," "bone mineralization," "growth," and "side effects" and limited to articles published in the last decade. The references cited by these articles were used to identify relevant older publications, with an emphasis on landmark studies essential to an understanding of the topic. Summary of the findings:Emphasis was placed on the actions of glucocorticoids on the hormones and cytokines that modulate linear growth. The end effects of glucocorticoids on the skeletal system are the result of systemic effects on bone metabolism and of direct actions on bone cells, which alter bone cell counts and predispose to bone loss. The mechanisms underlying catch-up growth and bone mass recovery after discontinuation of glucocorticoid treatment are discussed, followed by a review of diagnostic methods available for assessment of bone metabolism and mineralization and of measures for prevention and management of glucocorticoid-induced bone changes. Conclusion:Patient monitoring on a case-by-case basis plays an essential role in detection and, potentially, reversal of the damage associated with chronic glucocorticoid therapy. J Pediatr (Rio J). 2011;87(1):4-12:Glucocorticoids, steroids, growth, bone mineralization, growth retardation, child growth, children, adolescents, densitometry, bone mineral density, bone mineralization markers, bone. ResumoObjetivo: Revisar os mecanismos de ações dos glicocorticoides e sua capacidade de induzir osteoporose e déficits de crescimento. Fontes dos dados:A revisão bibliográfica de artigos científicos foi realizada na base de dados MEDLINE e utilizou as palavras-chave agrupadas nas sintaxes "glicocorticoides", "mineralização óssea", "crescimento" e "efeitos colaterais", nos últimos 10 anos, e das referências destes nos reportamos para as publicações mais antigas, mas com os estudos fundamentais para a compreensão do assunto. Síntese dos dados:Destacam-se ações dos glicocorticoides sobre hormônios e citocinas responsáveis pelo crescimento longitudinal. Os efeitos finais dos glicocorticoides sobre o esqueleto são determinados por ações sistêmicas no metabolismo ósseo e por ações diretas desses esteroides nas células ósseas, levando a mudanças no número e função das mesmas e favorecendo a perda óssea. Discutem-se os mecanismos indutores da recuperação dos canais de crescimento e recuperação da massa óssea após a descontinuação dos glicocorticoides; os métodos diagnósticos do metabolismo e mineralização óssea; assim como medidas terapêuticas e preventivas das alterações óssea induzidas pelos glicocorticoides.Conclusão: A monitorização de cada paciente é essencial para identificação e potencial reversão dos danos associados ao uso crônico de glicocorticoides. J Pediatr (Rio J). 2011;87(1):4-12:Glicocorticoide...

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Growth and endocrine function in steroid sensitive nephrotic syndrome.

Cited by 89 publications

References 24 publications

Growth in Children with Steroid Sensitive Nephrotic Syndrome

Growth in Children with Steroid Sensitive Nephrotic Syndrome

Evaluation of the advers effects of the treatment of nephrotic syndrome in children

Effects of glucocorticoids on growth and bone mineralization

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