Korean Journal of Nephrology 1990;9(2):195-201.

소아 특발성 신증후군에서 알레르기에 대한 연구

진동규 , 정해일 , 김중곤 , 최용 , 고광욱 , 김미경 , 김유영

Abstract

Osteomalacia is a well-documented problem of bone abnormalities in patients with nephrotic syndrome and result from low level of 25(OH)D,, in serum due to the loss of vitamine D binding protein in the urine. After steroid treatment, it is uncertain whether bone abnormalities are improved due to proteinuric resolu- tion or aggravated due to steroid-induced osteoporosis. We measured BMD at the lumber vertebrae (L,-L,) using dual energy X-ray absorptiometry in 28 patients with proteinuric glomerulonephritis; 15, nephrotic syn- drome (uring protein>3 g/day) and 13, non-nephrotic proteinuric renal disease and measured BMD in 15 healthy controls who were matched in age and sex. The relationship between biochemica] data and BMD were observed. Also, the changes of BMD were observed after steroid treatment in 8 steroid-treated patients with proteinuria. The results were as folJows: 1) In patients with nephrotic syodrome, serum 25-OH D, concentration was significantly lower than that of controls (p < 0.05) but BMD of 1 umbar vertebrae (L., L,) was not significantly different from that of non- nephrotic proteinuric patients and controls. 2) The bistologic pattern of glomerulonephritis showed no difference in BMD. 3) l here was no significant correlation between BMD and biochemical data such as serum albumin, globulin, creatinine, ionized calcium and 25(OH)D,. 4) After steroid treatment, BMD was not changed significantly. 5) There was no significant correlation between BMD and duration of treatment or amount of steroid. In conclusion, BMD vas not channged significatly after short-term steroid treatment in young nephrotic patients. But bone abnormalities in nephrntic patients with long-term steroid treatment should be further evaluated.