All issues > Volume 39(6); 1996

Original Article

J Korean Pediatr Soc. 1996;39(6):822-828. Published online June 15, 1996.

Effect of Steroid Therapy on Bone Mineral Density in Children with Minimal Change Nephrotic Syndrome

Byeong Hee BH Son¹, Woo Yeong WY Chung¹, Chul Ho CH Kim¹

¹Department of Pediatrics, Pusan Paik Hospital, College of Medicine, InJe University, Pusan, Korea

Abstract

Purpose
: Osteoporosis and growth failure have been known one of the serious side effects of corticosteroid therapy especially in children. This study was designed to evaluate the effect of long-term administration of steroids on bone mineral density(BMD) in children with nephrotic syndrome and its relationship to cumulative steroid dose, the duration of the rapy and sex.
Methods
: The BMD of the spine and arm were measured by dualenergy x-ray absorptiometry in 24 children with biopsy-proven minimal change nephrotic syndrome who have been revealed steroid dependent and/or frequent relapse in its clinical course and in age- and sex-matched healthy controls. The mean duration of steroid therapy was 37¡¾29.8 months and the mean cumulative steroid doses was 12.8¡¾7.7g/m2.
Results
: 1) The BMD at arm was 0.57¡¾0.06g/cm2 in patient group and 0.59¡¾0.06g/cm2 in control group. The BMD at spine was 0.68¡¾0.1g/cm2 in patient group and 0.76¡¾0.1g/cm2 in control group. Compared with control group significant decrease in BMD was detected in patient group at arm(p=0.011) and spine(p<0.01). The bone loss at spine and arm was -10.6¡¾7.44% and -3.7¡¾5.5%, respectively. The bone loss was more prominant at spine(p<0.01). 2) Bone loss at arm was significantly correlated to the total cumulative dose of steroid(Y=-0.0029-0.294X, r=-0.4148, p=0.0434), but was not correlated to the duration of steroid(Y=-2.15-0.04X, r=0.1396, p=0.4619). Atspine, there were no significant correlation between bone loss and the cumulative steroid doses(Y=-8.47-0.178X, r=-0.19397, p=0.363) and the duration of steroid therapy (Y=-9.75-0.025X, r=0.09081, p=0.6332).
Conclusion
: The long-term use of steroid can induce significant bone loss at the both site of arm and spine. To minimize the extent of corticosteroid-induced bone loss, BMD measurement using dual energy x-ray absorptiometry in children with nephrotic syndrome would be helpful.

Keywords :Minimal change nephrotic syndrome, Bone mineral density, Steroid