全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Study of the Effects of Glucocorticoid on Growth and Adult Final Height in Children with Primary Nephrotic Syndrome

DOI: 10.4236/ojneph.2024.141001, PP. 1-9

Keywords: Primary Nephrotic Syndrome, Glucocorticoid, Children, Growth Retardation, Adult Height

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objective: To analyze the epidemiological characteristics of growth, as well as factors associated with growth retardation in children with primary nephrotic syndrome (PNS), and to investigate the effect of glucocorticoid (GC) use duration on growth retardation in these children. Methods: Clinical and laboratory data of 353 PNS children treated at our hospital from July 2014 to June 2015 were collected through the medical record management system. Height, weight, and GC usage were recorded. Follow-up assessments were conducted in August 2022 for the original group, recording height, weight, and GC usage. Height and weight were evaluated using standard deviation scores (SDS). Categorical data were analyzed using chi-square test while continuous measurement data were analyzed using t-test or rank-sum test. Linear regression was used to assess the association between two single independent variables, and logistic regression analysis was used to screen for risk factors related to growth retardation in children with PNS. Results: Among the 353 PNS children enrolled in this study, male-to-female ratio of 2.64:1 (256 males vs 97 females). A total of 119 children exhibited growth retardation, incidence rate of 33.71%. The duration of GC usage among those with growth retardation was significantly longer compared to those without it (762.81 ± 934.50 days vs 263.77 ± 420.49 days; p < 0.05). There was a negative correlation between GC usage duration and height SDS (r = -0.406; p < 0.05). Telephone follow-up was conducted on 61 patients, with 14 (22.95%) exhibiting growth retardation. Among the 34 patients who reached final adult height, 11 (32.35%) was in the growth retardation group, accounting for 64.28% of the total growth retardation cases (9 out of 14). Conclusion: PNS children treated with GC have a high incidence of growth retardation, and a high proportion of short stature in adulthood, especially in children with growth retardation in childhood, most of them have short stature after grown up. Time of GC usage is a risk factor for growth retardation in children with PNS.

References

[1]  Aljebab, F., Choonara, I. and Conroy, S. (2016) Long-Course Oral Corticosteroid Toxicity in Children. The Neonatal and Paediatric Pharmacists Group (NPPG), 21st Annual Conference, Cheshire, 6-8 November 2015, 48.
https://doi.org/10.1136/archdischild-2016-311535.57
[2]  Simmonds, J., Grundy, N., Trompeter, R., et al. (2010) Long-Term Steroid Treatment and Growth—A Study in Steroid-Dependent Nephrotic Syndrome. Archives of Disease in Childhood, 95, 146-149.
https://doi.org/10.1136/adc.2007.129957
[3]  Hughes, D.T. (2012) Inhaled Glucocorticoids and Adult Height. The New England Journal of Medicine, 367, 2156-2157.
https://doi.org/10.1056/NEJMc1211948
[4]  Ribeiro, D., Zawadynski, S., Pittet, L.F., et al. (2015) Effect of Glucocorticoids on Growth and Bone Mineral Density in Children with Nephrotic Syndrome. European Journal of Pediatrics, 174, 911-917.
https://doi.org/10.1007/s00431-014-2479-z
[5]  Soliman, A.T., Madina, E.H., Abdel, F.M., et al. (1995) Nocturnal Growth Hormone (GH) Secretion and GH Response to Clonidine Provocation in Children before and after Long-Term Prednisone Therapy. Journal of Tropical Pediatrics, 41, 344-347.
https://doi.org/10.1093/tropej/41.6.344
[6]  Mohan, K.R. and Kanitkar, M. (2009) Growth in Children with Steroid Sensitive Nephrotic Syndrome. Medical Journal Armed Forces India, 65, 4-6.
https://doi.org/10.1016/S0377-1237(09)80043-9
[7]  Chinese Medical Association (2008) The Subspecialty Group of Endocrinologic. Guidelines for Diagnosis and Treatment of Children with Short Stature. Chinese Journal of Pediatrics, 46, 428-430.
[8]  Allison, A.E. and Jordan, M.S. (2003) Nephrotic Syndrome In Childhood. Lancet, 362, 629-639.
https://doi.org/10.1016/S0140-6736(03)14184-0
[9]  Wong, W. (2007) Idiopathic Nephrotic Syndrome in New Zealand Children, Demographic, Clinical Features, Initial Management and Outcome after Twelve-Month Follow-Up: Results of a Three-Year National Surveillance Study. Journal of Paediatrics and Child Health, 43, 337-341.
https://doi.org/10.1111/j.1440-1754.2007.01077.x
[10]  Chang, J.W., Tsai, H.L., Yang, L.Y., et al. (2012) Epidemiology and Predictors of End-Stage Renal Disease in Taiwanese Children with Idiopathic Nephrotic Syndrome. Journal of Epidemiology, 22, 517-522.
https://doi.org/10.2188/jea.JE20120033
[11]  Hevia, P., Nazal, V., Rosati, M.P., et al. (2015) Idiopathic Nephrotic Syndrome: Recommendations of the Nephrology Branch of the Chilean Society of Pediatrics. Parte One. Revista Chilena de Pediatría, 86, 291-298.
https://doi.org/10.1016/j.rchipe.2015.05.005
[12]  Sullivan, P.B. (2004) Commentary: The Epidemiology of Failure-to-Thrive in Infants. International Journal of Epidemiology, 33, 847-848.
https://doi.org/10.1093/ije/dyh199
[13]  Pawellek, I., Dokoupil, K. and Koletzko, B. (2008) Prevalence of Malnutrition in Paediatric Hospital Patients. Clinical Nutrition, 27, 72-76.
https://doi.org/10.1016/j.clnu.2007.11.001
[14]  Daniel, M., Kleis, L. and Cemeroglu, A.P. (2008) Etiology of Failure to Thrive in Infants and Toddlers Referred to a Pediatric Endocrinology Outpatient Clinic. Clinical Pediatrics, 47, 762-765.
https://doi.org/10.1177/0009922808316989
[15]  Li, H., Zhang, Y.-Q., et al. (2009) Height and Weight Standardized Growth Charts for Chinese Children and Adolescents Aged 0 to 18 Years. Chinese Journal of Pediatrics, 47, 487-492.

Full-Text

Contact Us

[email protected]

QQ:3279437679

WhatsApp +8615387084133