Ocular Complications in Children with Nephrotic Syndrome on Long Term Oral Steroids

Gaur, SN; Joseph, Mary; Nityanandam, S.; Subramanian, Sitalakshmi; Koshy, A; Vasudevan, Anil; Phadke, Kishore; Iyengar, Arpana

doi:10.1007/s12098-014-1338-2

Cited by 22 publications

(31 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The risk of cataracts was 4.7 per 1000 patient-years after initiation of steroid compared with 2.2 per 1000 patient-years when untreated with steroids. Steroid-associated cataracts have been reported in 10% to 27% of children with nephrotic syndrome who had routine prospective ophthalmologic evaluations 31, 32. Our cohort’s cumulative cataract frequency likely represents an underdocumentation in the EHR as well as an underdiagnosis.…”

Section: Discussionmentioning

confidence: 83%

Steroid-Associated Side Effects in Patients With Primary Proteinuric Kidney Disease

Waldo

Paez-Cruz

et al. 2019

Kidney International Reports

View full text Add to dashboard Cite

IntroductionThe goal of this study was to assess the occurrence of steroid-associated adverse events (SAAE) in patients with primary proteinuric kidney disease.MethodsThe Kidney Research Network Registry consists of children and adults with primary proteinuric kidney disease. SAAEs of interest were hypertension, hyperglycemia and diabetes, overweight and obesity, short stature, ophthalmologic complications, bone disorders, infections, and psychosis. Events were identified using International Classification of Diseases, Ninth Revision/Tenth Revision codes, blood pressures, growth parameters, laboratory values, and medications. Poisson generalized estimating equations tested the association between steroid onset and dose on SAAE risk.ResultsA total of 884 participants were included in the analysis; 534 (60%) were treated with steroids. Of these, 62% had at least one SAAE. The frequency of any SAAE after initiation of steroids was 293 per 1000 person-years. The most common SAAEs were hypertension (173.7 per 1000 person-years), diabetes (78.7 per 1000 person-years), obesity (66.8 per 1000 person-years), and infections (46.1 per 1000 person-years). After adjustment for demographics, duration of kidney disease, estimated glomerular filtration rate (eGFR), proteinuria, and other therapies, steroid exposure was associated with a 40% increase in risk of any SAAE (Relative risk [RR]: 1.4; 95% confidence interval [CI]: 1.3–1.6). A 1-mg/kg per day increase in steroid dose was associated with a 2.5-fold increase in risk of any SAAE.ConclusionMost patients with primary proteinuric kidney disease treated with steroids experienced at least one SAAE. Steroid therapy increased risk of hypertension, diabetes, weight gain, short stature, fractures, and infections after adjusting for disease-related factors. This study highlights the importance of surveillance and management of SAAE and provides rationale for the development of steroid minimization protocols.

show abstract

Section: Discussionmentioning

confidence: 83%

Steroid-Associated Side Effects in Patients With Primary Proteinuric Kidney Disease

Waldo

Paez-Cruz

et al. 2019

Kidney International Reports

View full text Add to dashboard Cite

show abstract

“…This was comparable to results from similar studies. Gaur found elevated IOP in 10.97% of the children with Nephrotic syndrome he examined in India (18). In Japan, 20% of children with nephrotic syndrome had elevated IOP(7).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of ocular complications among children with nephrotic syndrome in a resource-limited setting

Nakubulwa

Lusobya

Batte

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children with nephrotic syndrome receiving care at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three (3) months at pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71%(95%CI 61.1–79.6) and 56%(95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) P = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist.

show abstract

“…Percentage of occurrence of posterior subcapsular cataract is comparable with other studies. 6,7,8 Duration of steroid therapy was found to be associated with development of cataract. With a percentage of 6.2% at a duration of 1-3 years, it increased to 17.4% within 4-6 years duration.…”

Section: Discussionmentioning

confidence: 99%

A Study on Ocular Findings in Children With Nephrotic Syndrome

Jazeela¹,

Velayudhan²,

Chereyath³

et al. 2018

jebmh

View full text Add to dashboard Cite

BACKGROUNDNephrotic syndrome occurs when the filtering units of the kidneys-the glomeruli are damaged. The annual incidence of nephrotic syndrome ranges from 2-7 per 100,000 children. Oral corticosteroids form the cornerstone for management of most children with nephrotic syndrome. Long-term steroid therapy in childhood is associated with a number of significant adverse effectsmajor ophthalmic adverse effects include decreased vision, recurrent hordeolum, posterior subcapsular cataract, pseudotumour cerebri, visual hallucinations. This study aims to analyse the ocular findings in children with nephrotic syndrome, and their treatment related ocular abnormalities.

show abstract

Ocular Complications in Children with Nephrotic Syndrome on Long Term Oral Steroids

Cited by 22 publications

References 10 publications

Steroid-Associated Side Effects in Patients With Primary Proteinuric Kidney Disease

Steroid-Associated Side Effects in Patients With Primary Proteinuric Kidney Disease

Prevalence and predictors of ocular complications among children with nephrotic syndrome in a resource-limited setting

A Study on Ocular Findings in Children With Nephrotic Syndrome

Contact Info

Product

Resources

About