Evaluation of Biochemical Bone Markers in Children with Nephrotic Syndrome with Correlation to Its Severity

Abstract

Background: Vitamin D is a vital component of bone metabolism and calcium homeostasis, and its deficiency is known to cause rickets, osteomalacia and hypocalcemia. Objective: The aim of this study was to evaluate vitamin D level in patients with nephrotic syndrome and its relation to calcium. Patients and methods: This study was a case-control study carried out at Pediatric Nephrology Unit Pediatric Department, Faculty of Medicine, Zagazig University Hospitals from June 2020 to December 2020. It included 108 patients divided into 2 groups; each group included 54 patients.1st group was patients with nephrotic syndrome and 2nd group was healthy children as control group. A detailed history and clinical examination including anthropometry was taken for cases of Nephrotic syndrome admitted to the hospital. The patients underwent the following investigations: serum albumin, serum cholesterol, C3, C4, alkaline phosphatase, total calcium, ionized calcium, 25(OH) vitamin D, CBC, renal function test, urine analysis urine albumin/creatinine ratio, 24hr urine protein and X-ray bone. Results: There was statistically significant relation between vitamin D level and steroid response where steroid-resistant patient had lower vitamin level followed by steroid-dependent then steroid-sensitive patients. There was non-significant correlation between vitamin D and occurrence of relapse. Conclusion: Vitamin D and calcium supplementation should be considered in nephrotic patients.