Effect of galactose on proteinuria in pediatric steroid resistant nephrotic syndrome

Abstract

Introduction Proteinuria in steroid resistant nephrotic syndrome (SRNS) is associated with permeability factor (PF). Galactose has been shown to bind with PF, preventing its interaction with podocyte glycocalyx, and oral administration of galactose may lead to reduction of proteinuria. Aim of the study To study the effect of galactose on proteinuria in pediatric patients with steroid-resistant nephrotic syndrome. Patients and methods A prospective pilot clinical trial was conducted to investigate the effect of oral galactose on proteinuria in children with SRNS. Seven pediatric subjects with idiopathic SRNS were treated with oral galactose (0.2 g/Kg/dose twice daily) for 16 weeks. Monitoring parameters of improvement include clinical; vital signs, weight, absence of edema, frequency of albumin infusion, number of relapse, hospital admission and laboratory; 24 hour urine protein, serum albumin and serum creatinine. Results Study included seven patients, three of them showed clinical and laboratory improvement from the start till the end of therapy. One patient showed only clinical improvement from the start till the end of the therapy. Another patient improved clinically only after 8 weeks and then improved clinically and laboratory after 16 weeks. One patient was late responder (improved clinically and laboratory after 16 weeks) and one did not improve both clinically and laboratory all through the study. Conclusion The addition of galactose to conventional therapy in idiopathic SRNS is associated with clinical &/or laboratory improvement in most cases. Galactose intake may decrease the need of albumin infusion in resistant cases and hence, need for hospital admission.