Evaluation of the Level of Electrolytes in Children with Steroid Sensitive or Steroid Resistant Nephrotic Syndrome
DOI:
https://doi.org/10.32007/jfacmedbaghdad.6632270الكلمات المفتاحية:
Electrolyte، Estimated glomerular filtration rate (eGFR)، Idiopathic nephrotic syndromeالملخص
Background: Childhood idiopathic nephrotic syndrome is one of the most common conditions pediatric nephrologists encounter globally. Nephrotic syndrome is characterized by proteinuria, hyperlipidemia, and edema. The degree and duration of proteinuria have an impact on serum electrolyte levels. However, local data is limited.
Objectives: To assess and compare the degree of electrolyte imbalance and its relationship to kidney function indicators during relapse and remission in children with idiopathic nephrotic syndrome.
Methods: In this case-control study, blood samples were collected from 80 Iraqi children with an age range of (2-14) years. They were divided into three groups: Group I (20 individuals with steroid-sensitive nephrotic syndrome (SSNS)), Group II (20 individuals with steroid-resistant nephrotic syndrome (SRSN)), and Group III (40 healthy individuals as the control group). Serum electrolyte levels (Na, Ca, Cl, and K) were measured by an ion-selective electrode (9180 electrolyte analyzer). Blood creatinine and urea were measured by a Cobas c311 autoanalyzer during the relapse and remission phase. The patients were clients of the pediatric nephrology consultation center at the Children's Teaching Hospital / Baghdad Medical City and Al-Batoul Teaching Hospital for Women and Children from 15 February to 20 August 2022. The controls were healthy children whose medical history was reviewed to eliminate a history of kidney disease and underwent a comprehensive physical examination. Controls were recruited from a network of family, friends, relatives, and the National Autism Center/ Child Protection Teaching Hospital affiliated with Medical City/Baghdad.
Results: Serum Calcium levels showed a clear decrease in all SSNS and SRSN patients compared to the control group. The levels of Sodium and Chloride were significantly lower than the control group during the relapse phase. The results of the relapse phase of SRNS patients indicated higher serum potassium concentration compared with the control group and the SSNS patient group, with a statistically significant difference).
Conclusion: All children with idiopathic nephrotic syndrome had hypocalcemia in the relapse and remission phase. SRNS cases had hyperkalemia, Sodium, and chloride fluctuated between low levels during the relapse phase and normal levels during the remission phase.
التنزيلات
المراجع
Londeree J, McCracken CE, Greenbaum LA, Anderson EJ, Plantinga LC, Gillespie SE, et al. Estimation of childhood nephrotic syndrome incidence: data from the atlanta metropolitan statistical area and meta-analysis of worldwide cases. J Nephrol. 2022;35(2):575-583.
https://doi.org/10.1007/s40620-021-01108-9
Al-Mendalawi MD. Re: Thyroid Dysfunction in Children with Idiopathic Nephrotic Syndrome Attending a Paediatric Hospital in Qazvin, Iran. SQU Med J. 2021;21(2):332. https://doi.org/10.18295/squmj.2021.21.02.030
Al-taiee TAK, Al-shammaa NMJ. Effect of Anti Diuretic Hormon (ADH) in Kidney Function on Post Hemodialysis End Stage Renal Failure Disease (ESRD) Iraqi Patients. Iraqi J Sci. 2018;59(3):1372-7. https://doi.org/10.24996/ijs.2018.59.3B.4
Dian Anggraini P. Musalim, Risky Vitria Prasetyo, Danti Nur Indiastuti MRA. Correlation between Corticosteroid Therapy and Height in Childhood Nephrotic Syndrome : A Systematic Review. Int J Med Rev Syst Rev. 2021;8(4):150-7.
https://doi.org/10.30491/ijmr.2020.255218.1155
Mishra R, Kumari S, Pathak A, Prasad KN. Risk factors for relapse in pediatric nephrotic syndrome in Ranchi. J Fam Med Prim care. 2023;12(2):223-6
https://doi.org/10.4103/jfmpc.jfmpc_983_22
Al-kinani ZA, Ali SH. Serum Chitotriosidase Level as a Novel Biomarker for Therapeutic Monitoring of Nephropathic Cystinosis among the Iraqi children. Iraqi J Pharm Sci. 2021;30(1):270–6. https://doi.org/10.31351/vol30iss1pp270-276
Al-Mendalawi MD. Thyroid Profile in Idiopathic Childhood Steroid Sensitive Nephrotic Syndrome. Med J Dr DY Patil Vidyapeeth. 2022;15:953. https://doi.org/10.4103/mjdrdypu.mjdrdypu_189_20
Takemasa Y, Fujinaga S, Nakagawa M, Sakuraya K, Hirano D. Adult survivors of childhood-onset steroid-dependent and steroid-resistant nephrotic syndrome treated with cyclosporine: a long-term single-center experience. Pediatr Nephrol. 2023;10.1007/s00467-023-06108-4. .https://doi.org/10.1007/s00467-023-06108-4.
Mohammed A, Alridha A, Kadhim DJ, Hussein A, Alkhazrajy A. Association of the rs1128503 and rs1045642 polymor- phisms in the MDR-1 gene with steroid responsiveness in Iraqi children with idiopathic nephrotic syndrome. Pharm Sci Asia. 2023;50(3):187-95.
https://doi.org/10.29090/psa.2023.03.23.245
Esezobor I CH, Solarin AU, Gbadegesin R. Changing epidemiology of nephrotic syndrome in Nigerian children : A cross- sectional study. PLOSONE. 2020;15(9):1–11. http://dx.doi.org/10.1371/journal.pone.0239300
Azat NFA. Evaluation of Serum (immunoglobulin G, M) in children with nephrotic syndrome relapse. J Fac Med Baghdad. 2012;54(1):15-7.
https://doi.org/10.32007/jfacmedbagdad.541763
Al-taiee TAK., Al-shammaa NMJ. and Aljber AA. Study of the Anti-Diuretic Hormone (ADH) on End Stage Renal Failure Disease (ESRD) Pre-Hemodialysis in Iraqi Patients. Ibn Al-Haitham Jour Pure Appl Sci 32. 2019;32) 2). https://doi.org/10.30526/32.2.2135
Hanoudi BMRMKWA-K. Study of Factors Associated with Childhood Nephrotic Syndrome, Frequent Relapsing and Infrequent Relapsing Type. Al-Kindy Coll Med J. 2014;10(1):71–7.
Jaber B A; Azat N F A; Al-Daffaie A A. COMPLICATIONS OF NEPHROTIC SYNDROME IN CHILDREN. Wiadomosci lekarskie (Warsaw, Poland:1960), (2022); 75(9 pt 2), 2226–2232. https://doi.org/10.36740/wlek202209209
Pottel H, Hoste L, Delanaye P. Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL / min / 1. 73 m 2. Pediatr Nephrol. 2015;30(5):821–8.
https://doi.org/10.1007/s00467-014-3002-5
Patil S, Biradar SM, Holyachi R, Devarmani S, Reddy S. Assessment of Serum Electrolytes and Glycated Hemoglobin Level in Non-diabetic Iron-Deficient Anaemic Patients. Cureus. 2023;15(5):e38656.
https://doi.org/10.7759/cureus.38656
Mohammed A, Alridha A, Kadhim DJ, Hussein A, Alkhazrajy A. The Potential of Vitamin-D-Binding Protein as an Urinary Biomarker to Distinguish Steroid-Resistant from Steroid-Sensitive Idiopathic Nephrotic Syndrome in Iraqi Children. Siriraj Med J. 2023;75(4):248–58.
https://doi.org/10.33192/smj.v75i4.260831
Rodriguez-ballestas E, Reid-adam J. Nephrotic Syndrome. Pediatr Rev.2022;43(2):87-99.
https://doi.org/10.1542/pir.2020-001230.
Niaudet, P. Nephrotic Syndrome: Classification and Evaluation. Pediatric Nephrology, 2021. https://doi.org/10.1007/978-3-642-27843-3_24-3.
Schwartz, G. J.; Muñoz, A.; Schneider, M. F.; Mak,R. H; Kaskel, F.; Warady, B. A.; Furth, S. L. New equations to estimate GFR in children with CKD. Journal of the American Society of Nephrology, 2009; 20,3, 629–637 https://doi.org/10.1681/ASN.2008030287
Shah PP, Brady TM, Meyers KEC, O’Shaughnessy MM, Gibson KL, Srivastava T, et al. Association of Obesity with Cardiovascular Risk Factors and Kidney Disease Outcomes in Primary Proteinuric Glomerulopathies. Nephron. 2021;145(3):245–55. https://doi.org/10.1159/000513869
Hossain A. Correlation Between Serum Albumin Level and Ionized Calcium in Idiopathic Nephrotic Syndrome in Children. Urol Nephrol Open Access J. 2016;3(2):44–7. https://doi.org/10.15406/unoaj.2016.03.00070
Faisal Amin A, Mohamed Rabeea M, Abd El-Rahman Elzarea G, Abd El-Aziz Ahmed S. Audiometric Evaluation for Children with Idiopathic Nephrotic Syndrome. Al-Azhar Med J. 2022;51(2):1133–44. https://doi.org/10.21608/AMJ.2022.230476
Basu AK, Chakraborty A, Sit S, Jana JK, Maiti S, Mandal AK. Thyroid Function Status in Nephrotic Syndrome in Paediatric Age Group: A Hospital-based Cross-sectional Study. J Clin Diagnostic Res. 2022;16(12):10–3.
https://doi.org/10.7860/JCDR/2022/59062.17369
Ydegaard R, Svenningsen XP, Bistrup XC, Andersen RF, Stubbe J, Buhl KB, et al. Nephrotic syndrome is associated with increased plasma K+ concentration, intestinal K+ losses, and attenuated urinary K+ excretion: a study in rats and humans. Am J Physiol Ren Physiol. 2019;317(16):1549–62. https://doi.org/10.1152/ajprenal.00179.2019
Thakor JM, Mistry KN, Gang S. Association between serum calcium and biochemical parameters among nephrotic syndrome patients: a case-control study. Egypt Pediatr Assoc Gaz. 2022;70(1):4–9. https://doi.org/10.1186/s43054-022-00110-5
Andersen RF, Nørgaar, H, Hagstrøm S, Bjerre, J Jespersen B, Rittig, S. High plasma aldosterone is associated with a risk of reversible decreased eGFR in childhood idiopathic nephrotic syndrome. Nephrol Dial Transpl. 2013;28:944–52. https://doi.org/10.1093/ndt/gfs527
Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney international, 2022; 102,5S, S1-S127. https://doi.org/10.1016/j.kint.2022.06.008
التنزيلات
منشور
إصدار
القسم
الرخصة
الحقوق الفكرية (c) 2024 Ahmed H. Alwan, Nawal M. Al-Shammaa
هذا العمل مرخص بموجب Creative Commons Attribution 4.0 International License.