European Journal of Molecular & Clinical Medicine

Introduction: Nephrotic Syndrome is characterised by nephrotic range proteinuria and the triad of clinical findings i.e., hypoalbuminemia, edema and hyperlipidemia. Glucocorticoid-sensitive nephrotic syndrome remits completely and quickly in response to glucocorticoids. Steroids are known to cause osteoporosis and loss of bone mineral density in NS patients.  So, we decided to study requirement of vitamin D in nephrotic syndrome in patients who are on remission during steroid therapy and Comparison of normal and high dose of vitamin D supplementation to achieve normal vitamin D level in nephrotic syndrome patient, in remission on prednisolone therapy.
Material And Methods: The present descriptive observational study, was conducted amongst 31 patients from August 2014 to August 2016 in the pediatric department of tertiary care centre on both indoor (IPD) and outdoor (OPD) patients of Nephrotic syndrome those who are in remission on steroid. Patients having normal 25 OH Vitamin D level were included in study. These patients were randomly divided in two groups using random sampling by lottery method. a. First group was given vitamin D therapy as 20, 000 IU/month (600IU/day) for three months b. Second group was given 60,000 IU /month (2000IU/day) for three month.
Results: Out of 31 patients in this study, mean age at inclusion in group A was 5.4 years whereas, it was 7.2 years in group B. Majority 12 of the patients were having SDNS as diagnosis. Both the groups showed elevated levels of 25(OH) after supplementation.  The levels of serum ionic calcium levels were not affected in both the groups, but the mean values of serum Ionic Calcium was found to be on higher side after Calcium supplementation especially in group B. The serum values were not affected in both groups.
Conclusion: The results concludes that there is no need for vitamin D supplementation in higher doses in steroid-sensitive nephrotic syndrome in patients those who are in remission and on minimal dose of steroids. So, dosage of vitamin D should be according to Recommended Dietary Allowances (RDA) when patient is on minimal dose of steroids.

The incidence of Nephrotic Syndrome is 2-7 cases per 1, 00,000 children per year and prevalence is nearly 16 cases per 1,00,000. Various infections are considered as most important complications of Nephrotic Syndrome associated with high mortality. Loss of complement factors in urine is one of the major factors in etiopathogenesis of infections. Acute Renal Failure was also described as one of the complications of Nephrotic Syndrome. The present study was carried out to study the incidence and severity of infections in Nephrotic Syndrome with respect to various parameters like the age of patients, number of relapses, duration of disease and mortality. Methods: The present descriptive observational study was conducted in indoor (IPD) and outdoor (OPD) patients in the pediatric department of tertiary care center amongst 82 Nephrotic syndrome patients visiting for various infectious complications from August 2013 to August 2015. Results: Maximum incidence was found in the age of 1-3 years (37%) and male predominance (61%) was seen.Commonest symptom was generalised swelling/facial puffiness (92%), followed by fever (58%), cough (48%). Anasarca was commonest sign (92%), followed by pallor (39%), Scrotal/Vulval edema (22%). 31% were infrequent relapsers and 22% were frequent relpasers.On Ultrasonography, ascites was the commonest finding in 42% of patients and on Chest radiographs, perihilar opacities were seen in 40% of patients. 49% of patients had respiratory tract infections and 34% of patients had Urinary Tract Infections. Conclusions: From our study we concluded that infections are found to be common complication of Nephrotic Syndrome amongst of which respiratory tract infection appears to be the commonest infection. WhileSerum Albumin and Serum Immunoglobulin levels are considerably low while serum cholesterol level is considerably high in severe infections requiring hospitalization.

Background: Nephrotic syndrome is a collection of clinical findings due to kidney damage. This includes protein in urine, low blood albumin levels, high blood lipids, and significant edema. The main cause of hyperlipidemia in patients with NS is probably increased hepatic lipogenesis, a non-specific reaction to falling oncotic pressure secondary to hypoalbuminemia. Hyperlipidemia is usually observed during the active phase of the disease and disappears with resolution of proteinuria. However, it may persist in some cases, leading to increased risk of atherosclerosis in later life and development of progressive renal injury. The current study was carried out to evaluate dyslipidemia in children with nephrotic syndrome.
Methods: This prospective cohort study was carried out at outpatient and inpatient units of Department of Pediatrics, JLN Medical College, Ajmer, Rajasthan, India during January 2020 to December 2020. A total of 60 consecutive children aged between one year and 18 years with newly diagnosed nephrotic syndrome or presenting with relapse of the disease. All patients were routinely monitored with daily weight, BP, abdominal girth, intake/output chart and urine albumin. Patients previously diagnosed with nephrotic syndrome with relapse were also admitted. Serum lipid profile was done by standard methods at three points of time: during disease activity, after attainment of remission and two weeks after completion of steroid therapy in steroid responsive nephrotic syndrome.
Results: Lipid parameters including mean total cholesterol, Triglyceride, LDL and VLDL were elevated at admission and these levels reduced significantly at remission and at completion of steroid therapy (All p values<0.001). There was significant elevation of mean total cholesterol level in case of relapse as compared to the first episode of nephrotic syndrome (p=0.048), however, LDL, VLDL and HDL were not significantly different. There was significant elevation of total cholesterol level at admission in subsequent relapses as compared to first episode of nephrotic syndrome (p=0.01).
Conclusion: In children with nephrotic syndrome, lipid parameters including mean total cholesterol, Triglyceride, LDL and VLDL were elevated at admission and these levels reduced significantly at remission and at completion of steroid therapy. Total cholesterol level was significantly elevated in children with relapse as compared to those with first episode of nephrotic syndrome.