Bone loss, which is a common side effect of treatment based on steroids for adults, does not affect children with nephrotic syndrome who are administered with steroid drugs.
Childhood nephrotic syndrome, which is believed to affect 3 out of 100,000 children, results in reduced ability of the body for removing salt and water from the blood and leads to swelling in the belly, legs, and around the eyes.
From News-Medical.Net:
“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 that findings of the report can be of great use for assuring patients and physicians about steroid-based treatment besides helping children with nephrotic syndrome as steroids do not enhance their risk of osteoporosis.
