Parathyroid Hormone, Osteocalcin, and Bone Mineral Density in Children with Steroid-Dependent and Frequently-relapsing Nephrotic Syndrome.
Soliman, G., Fouda, M., Sayed, S., Malek, I. (2004). Parathyroid Hormone, Osteocalcin, and Bone Mineral Density in Children with Steroid-Dependent and Frequently-relapsing Nephrotic Syndrome.. EKB Journal Management System, 4(1), 71-77. doi: 10.21608/geget.2004.46081
Gamal Soliman; Mohamed Fouda; Samira Sayed; Ishak Malek. "Parathyroid Hormone, Osteocalcin, and Bone Mineral Density in Children with Steroid-Dependent and Frequently-relapsing Nephrotic Syndrome.". EKB Journal Management System, 4, 1, 2004, 71-77. doi: 10.21608/geget.2004.46081
Soliman, G., Fouda, M., Sayed, S., Malek, I. (2004). 'Parathyroid Hormone, Osteocalcin, and Bone Mineral Density in Children with Steroid-Dependent and Frequently-relapsing Nephrotic Syndrome.', EKB Journal Management System, 4(1), pp. 71-77. doi: 10.21608/geget.2004.46081
Soliman, G., Fouda, M., Sayed, S., Malek, I. Parathyroid Hormone, Osteocalcin, and Bone Mineral Density in Children with Steroid-Dependent and Frequently-relapsing Nephrotic Syndrome.. EKB Journal Management System, 2004; 4(1): 71-77. doi: 10.21608/geget.2004.46081

Parathyroid Hormone, Osteocalcin, and Bone Mineral Density in Children with Steroid-Dependent and Frequently-relapsing Nephrotic Syndrome.

GEGET
Article 8, Volume 4, Issue 1, August 2004, Page 71-77  XML PDF (925.52 K)
Document Type: Original Article
DOI: 10.21608/geget.2004.46081
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Authors
Gamal Soliman1; Mohamed Fouda1; Samira Sayed2; Ishak Malek2
1Department of Pediatrics, El-Minia University, El-Mansoura Urology and Nephrology Center, Egypt.
2Ministry of Health and population, Egypt.
Abstract
Background: A long-term corticosteroid treatment is often required for children with nephrotic syndrome, which may affect their bone metabolism.
Objectives: The aim of this work was to study bone mineral density (BMD) and some laboratory markers of bone metabolism (serum osteocalcin, parathyroid hormone, and serum alkaline phosphatase) in a group of nephrotic children who received multiple courses prednisone.
Methods: We measured serum calcium, phosphorus, alkaline phosphatase (AP), osteocalcin (OC) and parathyroid hormone (PTH) in 30 children aged 3.8 to 12 years with steroid-dependent and frequently-relapsing nephortic syndrome (21 males and 9 females), and in 15 age and sex matched controls. Measurement of bone mineral density (BMD) was performed for patients and controls using quantitative computed tomography (QCT).
Results: Nephrotic children had significantly lower serum levels of alkaline phosphatase (189.9 ± 15.4 IU/I), and osteocalcin (1.7 ± 1.5 ng/ml) compared with controls (226.6 ± 85.5 IU/I and 4.8 ± 1.1 ng/ml, respectively), p ≤ 0.05 for each. Also, BMD was significantly lower in patients (118.2 ± 26.5 gm/cm³) compared with controls (150.3 ± 33.5 gm/cm³), p ≤ 0.05. A significantly positive correlation was found between BMD and serum osteocalcin level (R: 0.447, P: ˂ 0.05), and a significant negative correlation was found between BMD and total dose of prednisone (R:-0.546, p: ˂ 0.01).
Conclusions: Repeated courses of prednisone used for treatment of children with steroid-dependent and frequently-relapsing nephrotic syndrome lead to decreased bone mineral density with decreased serum levels of osteocalcin and alkaline phosphatase, while serum PTH remains normal in the absence of hypocalcemia. 
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