Study of prevalence of vitamin D deficiency in nephrotic syndrome

Abstract

Background: Patients with nephrotic syndrome (NS) lose 25-hydroxyvitamin D in the urine and can have low blood levels of this metabolite. Corticosteroid therapy on long term basis can cause osteoporosis and affects the bone mineral content (BMC) and bone mineral density (BMD) in children. Hence this study was undertaken to study the prevalence of Vitamin D deficiency in children with Nephrotic syndrome.Methods: It is a time bound prospective hospital based observational study done at Department of Paediatrics, KIMS Hospital, Hubli. A detailed history and clinical examination including anthropometry was taken for cases of Nephrotic syndrome admitted to the hospital. 5ml venous blood was collected and sent for estimation of calcium (Ca), phosphorus (P), Alkaline phosphatase (ALP) and 25(OH) Vitamin D levels.Results: Mean age of onset of nephrotic syndrome was 4.6 years and median age at study entry was 7 years. Male to female ratio was 1.4:1. Vitamin D deficiency was present in 16(47.05%) children and insufficiency was present in 11(32.35%) children with nephrotic syndrome. Wasting was present in 11.76% and stunting was present in 50% of the children with nephrotic syndrome. There was no statistically significant difference of vitamin D levels with respect to sex and age group. Frequent relapsers had low levels of vitamin D levels as compared to 1st episode and infrequent relapsers. There was moderately significant positive correlation between serum calcium and vitamin D levels and negative correlation between phosphate levels and vitamin D levels.Conclusions: Vitamin D deficiency is common in children with nephrotic syndrome even after the remission of proteinuria.