ESPN 50th Annual Meeting

ESPN 2017


 
Vitamin D deficiency – risk factor for growth retardation in children with idiopathic nephrotic syndrome?
VENETSIYA BOTZOVA 1 EMILIA KOSTADINOVA 2 STANIMIRA ELKINA 1 PAVLINA LALEVA 3 CHAYKA PETROVA 1 NACHKO TOTZEV 4 AYLIN SABRI 1

1- UNIVERSITY HOSPITAL, DEPARTMENT OF PEDIATRICS, PLEVEN, BULGARIA
2- UNIVERSITY HOSPITAL, DEPARTMENT OF PEDIATRICS, STARA ZAGORA, BULGARIA
3- UNIVERSITY HOSPITAL, DEPARTMENT OF CLINICAL LABORATORY, PLEVEN, BULGARIA
4- UNIVERSITY HOSPITAL, DEPARTMENT OF ROENTGENOLOGY AND RADIOLOGY, PLEVEN, BULGARIA
 
Introduction:

 

The children with idiopathic nephrotic syndrome /INS/ are at increased risk of Vitamin D /VitD/ deficiency duе to long-term steroid treatment, protein-calorie malnutrition and urinary loss of VitD-binding protein. It is known that high-dose steroid therapy impairs normal growth. Is the VitD deficiency also a risk factor for growth retardation?
Aim: To determine the VitD status in children with steroid sensitive INS and to analyze the correlation between VitD deficiency and growth retardation.

Material and methods:

 

We report observation in 32 children -14 girls and 18 boys (age 8,24±4,2 yr) with INS and normal renal function. Height was expressed as SD scors /HtSDS/, using references for Bulgarian healthy children and WHO growth  standarts. Serum levels of 25(OH)D and PTH were assayed. Bone age was assessed according to Greulich&Pyle.

Results:

We found short stature (mean HtSDS -2,3) in 9,38%ofallpatients. In 18,75%  growth retardation (mean HtSDS -1,4) and in 71,87% of the children normal height for age were established/p=0,0001/. The children with severe VitD deficiency showed significant growth impairments (22,2% - short stature; 44,4% - growth retardation), than these with VitD insufficiency (16,67% - growth retardation) and normal VitD status (9,1% - short stature) /p<0,05/. Retardation of bone age in seven nephrotic children was established. The serum levels of 25(OH)D showed a significant negative correlation with alterations in the height /p=0,009;r =-0,41/. We found no relationship between VitD level and bone age/p>0,05/.

Conclusions:

 

The results of our study show that children with INS andVitD deficiency are at high risk of growth retardation. VitD supplementation is required in conditions with insufficiency or deficiency in order to prevent growth impairment.