Requirement of Vitamin D in Patients with Nephrotic Syndrome on Long Term Steroid
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 848-858
AbstractIntroduction: 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.
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