International Journal of Contemporary Pediatrics | July-August 2018 | Vol 5 | Issue 4 Page 1588 International Journal of Contemporary Pediatrics Sinha N et al. Int J Contemp Pediatr. 2018 Jul;5(4):1588-1593 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Original Research Article Biochemical bone markers in children with steroid sensitive nephrotic syndrome in remission Neha Sinha 1 , Poonam Wade 1 *, Radha Gulati Ghildiyal 1 , Hemil Maniar 2 , INTRODUCTION In children, the most frequent glomerular disease is idiopathic nephrotic syndrome which involves histological abnormalities of the kidney including minimal changes, focal segmental glomerulosclerosis and diffuse mesangial proliferation. 1 Nephrotic Syndrome (NS) often has a relapsing course and usually responds to steroids. 2 The loss of vitamin D metabolites in urine combined with the detrimental effect of corticosteroids (CS) often leads to disturbances in calcium (Ca) and vitamin D metabolism in nephrotic children. 3 The onset and subsequent relapses of NS and its treatment may disrupt active bone formation and mineral deposition during childhood. 4 ABSTRACT Background: Glucocorticoids, the recommended first line treatment of steroid sensitive nephrotic syndrome (SSNS), are notorious for causing osteoporosis. There are very few studies from tropical countries looking at the lasting effects of a short course of glucocorticoids in SSNS. The objective is to study the effect of glucocorticoids and its dose on Vitamin D levels and biochemical markers of calcium metabolism in children with SSNS and to formulate a criterion to administer prophylactic calcium and vitamin D supplementation to such patients. Methods: A cross-sectional case-control study was conducted on 30 children with SSNS in remission and 30 healthy controls. Serum levels of 25 hydroxycholecalciferol [25(OH)D], calcium, phosphorous, albumin, alkaline phosphatase (ALP) and intact parathyroid (PTH) were measured. Total glucocorticoid exposure during the illness was summarized. Results: Children with SSNS had significantly lower height [median-100.00 (interquartile range {IQR}- 14.5) vs. controls [115.50 (17.5)] cm; P= 0.0003. Serum ALP levels was significantly higher in the cases [median 264 (IQR- 80.7)] IU/L vs. controls [median 234 (IQR- 132)] IU/L; P= 0.028. Though hypovitaminosis D was universal in the study cohort; children with SSNS had worse Vitamin D status (76.7%) than healthy controls (50%). Levels of serum calcium, phosphorous, vitamin D and PTH were not significantly different between the two groups, nor were they related to total cumulative dose of steroid. Vitamin D levels showed no significant co-relation with number of relapses, age, calcium, phosphate, ALP, or PTH levels. Conclusions: Children with SSNS may benefit from routine measurement of 25 (OH) D and prophylactic supplementation with calcium and Vitamin D. Keywords: Glucocorticoids, Steroid sensitive nephrotic syndrome (SSNS), Vitamin D 1 Department of Pediatrics, T.N.M.C and B.Y.L Nair Hospital, Mumbai, Maharashtra, India 2 Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA, USA Received: 05 May 2018 Accepted: 05 June 2018 *Correspondence: Dr. Poonam Wade, E-mail: poonamwade@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20182570