153 Summer 2023. Volume 11. Number 3 Shabnam Khansari 1 , Behnaz Bazargani 1 ,Arash Abbasi 1 , Daryoush Fahimi 1 , Fahimeh Askarian 1 , Mastaneh Moghtaderi 1* 1. Pediatric Chronic Kidney Disease Research Center, Gene, Cell & Tissue Research Institute, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Original Article Investigating Steroid-associated Peptic Symptoms in Patients With Primary Nephrotic Syndrome Background and Aim: Nephrotic syndrome is the most common glomerulopathy among children aged 2-10 years old and high doses of corticosteroids are the cornerstone of its management. Whether corticosteroid use induces peptic ulcer disease in these patients remains uncertain. This study explores any relation between steroids and peptic symptoms in these children. Methods: A total of 100 nephrotic syndrome patients aged 1 to 15 years old treated with oral prednisolone in our Outpatient Department were studied. In this study, we compared nephrotic syndrome patients receiving 2 mg/kg prednisolone daily for 1 month and afterward as every other day until tapering off in about 3-6 months. They were divided into groups. One received aluminum Mg (Al-Mg) or proton pump inhibitors (PPIs) as prophylaxis and the other 50 patients did not receive any prophylaxis. These two groups are investigated for any gastro-intestinal complications. Heartburn, hematochezia, nausea, and dyspepsia are the four complications that were studied. In addition to investigating the relation of each of these complications with prednisolone consumption, we introduced a new variable named digestive complications for patients who have at least one of the above symptoms. Any relationship between steroid consumption and digestive complications and the effect of prophylactic drugs in preventing these complications are investigated Results: In this study, the data from 100 patients (61 male and 39 female) were analyzed. Accordingly, 46% of the patients consumed 0.5 mg/kg prednisolone every other day and 19% of the patients consumed 2 mg/kg prednisolone daily. In 51% of patients the duration of treatment was more than 6 months and in 19% of cases it was less than a month. Also, among the 68% of the patients who did not take PPIs, none experienced any digestive symptoms, including hematochezia. Among those patients who received prophylactic, PPIs one patient with less than a month of prednisolone taking and one who took prednisolone for more than six months contracted hematochezia. Overall, this study demonstrated no significant relationship between PPI prophylaxis and the occurrence of gastric symptoms. Based on the results, 12 out of 100 patients with heartburn and nausea were investigated and there was no relation between PPI consumption and their symptoms. A total of 80% of patients did not receive Al-Mg and there was no significant relation between Al-Mg consumption and dyspepsia. However, there was a significant relationship between Al-Mg and heartburn (P=0.004). Meanwhile, 50 patients in this study consumed Al-Mg or PPIs and a significant relationship was not observed between utilization of these drugs and hematochezia, melena, and heartburn. On the other hand, there was no relation between heartburn and dyspepsia (P=0.024). A B S T R A C T Corresponding Author: Mastaneh Moghtaderi, Associate Professor. Address: Pediatric Chronic Kidney Disease Research Center, Gene, Cell & Tissue Research Institute, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. .E-mail: Drmoghtaderi@ gmail.com ِCitation Khansari Sh, Bazargani B, Abbasi A, Fahimi D, Askarian F, Moghtaderi M. Investigating Steroid-associated Peptic Symptoms in Patients With Primary Nephrotic Syndrome. Journal of Pediatric Nephrology. 2023; 11(3):153-157. https://doi. org/10.22037/jpn.v11i3.43949 https://doi.org/10.22037/jpn.v11i3.43949 Use your device to scan and read the article online Article info: Received: 24 Nov 2022 Accepted: 19 Dec 2022 Publish: 01 Jul 2023 Copyright © 2023 The Author(s); This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC: https://creativecommons.org/licenses/by-nc/4.0/legalcode.en), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.