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According to a new study, children who use steroid drugs for nephrotic syndrome do not suffer from osteoporosis, which is a common side effect of steroid treatment methods in adults.
Childhood nephrotic syndrome, which is thought to affect 3 out of 100,000 children, is one of the most common chronic kidney diseases in children. Although it does not impair kidney function, it weakens ability of the body to remove salt and water in the blood causes swelling of the legs and stomach and around the eyes.
“Unlike other childhood diseases treated with steroid drugs, such as inflammatory bowel disease or juvenile rheumatoid arthritis, nephrotic syndrome resolves quickly when treated,” said pediatric nephrologist Mary B. Leonard, M.D., of The Children’s Hospital of Philadelphia, lead author of the study. “We specifically chose steroid-sensitive nephrotic syndrome because we are able to isolate the drug’s effects on bones, without having an underlying systemic disease simultaneously affecting the bones.”
The team led by Dr. Leonard compared 60 children and adolescents with steroid-sensitive nephrotic syndrome to 195 healthy children. Specialized X- ray measurements showed no signs of osteoporosis, a loss in bone mass, among the nephrotic syndrome patients. The study appeared in the August 26 New England Journal of Medicine.
The researchers made adjustments for body mass index, an important consideration, since 38 percent of the children in the nephrotic syndrome sample were obese (in contrast, only 16 percent of the control subjects were obese, a proportion consistent with the general pediatric population). The disproportionate obesity among children with nephrotic syndrome disappears after the patients discontinue steroid treatments.
“While steroids tend to make children shorter and heavier than healthy children, increased weight is associated with an increase in bone mass,” said co-author Babette Zemel, Ph.D., of the Nutrition Center at Children’s Hospital. Specifically, whole-body measurements of bone mineral content were higher in children with nephrotic syndrome than in healthy children.
Dr. Leonard said that the findings of this report may be used to assure parents and doctors about steroid treatments too help children with nephrotic syndrome that steroids do not increase their risk of osteoporosis.
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