Endocrine Abstracts

Steroid-associated adverse events (SAAE) include hypertension, hyperglycemia, and diabetes, overweight and obesity and short stature.

Aim: The goal of this study was to assess the occurrence of steroid-associated metabolic and clinical adverse events (SAAE) in patients with NS and frequent relapses treated with long-term prednisone compared to another high-risk group (obese children BMISDS > 2)

Methods: Data of 30 children with SSNS was analysed retrospectively. They received prednisolone only in the standard dose for the initial episode at 2 mg/kg/day for six weeks followed by 1.5 mg/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. The cumulative dose of steroids over the period of 5 years was calculated for each child. The growth data was recorded along the treatment period. The different metabolic criteria including impaired fasting glucose (IFG), high LDL and cholesterol, lower HD and high blood pressure for age and sex were studied over this period of time and compared with the data for 66 age-matched obese non-nephrotic children.

Results: Comparison between the NS group treated for an average of 5 years with prednisone (cumulative dose=125 +/- 28 mg/kg/yr.) and the non-nephrotic obese group showed that short stature (HtSDS < -2), impaired fasting glucose (IFG), high cholesterol, triglycerides (TG) and LDL levels occurred more significantly in the NS group. Hypertension was detected in 28 % of the NS group vs 12.5% in the obese group. (Table)

Conclusion: In children with SSNS and frequent relapses, long-term steroid therapy was associated with higher rate of obesity, short stature as well as the occurrence of different MetS abnormalities including hypertension, dysglycemia, and dyslipidaemias compared to age matched obese children.