IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 10 Ver. 11 (October. 2018), PP 60-64 www.iosrjournals.org DOI: 10.9790/0853-1710116064 www.iosrjournals.org 60 | Page “An estimation of Serum Prednisolone in Children with Nephrotic Syndrome: A study in a tertiary care hospital, Dhaka, Bangladesh” Dr. Abu Bakkir Siddique 1 , Dr. Mahmudul Hoque Chowdhury 2 , Dr. Md. Kamruzzaman 3 , Dr. Md. Mosharaf Hossain 4 1. Resident Medical Officer (MBBS, MD), Dhaka Shishu (Children) Hospital 2. Resident Medical Officer (MBBS,DCH), Dhaka Shishu (Children) Hospital 3.Assistant Professor (MBBS, DCH, DTCD), Paediatric Respiratory Medicine, Bangladesh Institute of Child Health & Dhaka Shishu (Children) Hospital 4.Assistant Professor (MBBS,DCH), Paediatric Respiratory Medicine, Bangladesh Institute of Child Health & Dhaka Shishu (Children) Hospital. Corresponding author: Dr. Abu Bakkir Siddique Abstract: Poor absorption of prednisolone is very uncommon, but an absorption study may be useful confirmatory evidence of poor concordance in a patient who denies not taking Prednisolone. Nephrotic syndrome, or nephrosis, is defined by the presence of nephrotic-range proteinuria, edema, hyperlipidemia, and hypoalbuminemia. While nephrotic-range proteinuria in adults is characterized by protein excretion of 3.5 g or more per day but in children it is defined as protein excretion of more than 40 mg/m2/h or a first-morning urine protein/ creatinine of 2-3 mg/mg creatinine or greater. Prednisolone is a steroid medication used to treat children with nephrotic syndrome which is frequently used. The aim of this study was to estimate serum Prednisolone in children with nephrotic syndrome in active phase and in remission. This was an prospective observational study done in the department of Paediatric Nephrology & Kidney diseases, Dhaka Shishu (Children) Hospital, Sher - E - Bangla Nagar, Dhaka and Clinical Pharmacy & Pharmacology Dept. University of Dhaka from January 2014 to December 2014. Serum Prednisolone was measured by enzymatic colorimetric method. The serum Prednisolone was measured in nephrotic syndrome during active phase & in remission and the average values were 2.088795 mic. mol/ml & 2.175277 mic.mol/ml respectively which was significantly high in remission of NS. Key words: Nephrotic syndrome, hypoalbuminemia, Serum Prednisolone, --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 16-10-2018 Date of acceptance: 31-10-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Prednisolone is a part of a group of drugs called corticosteroids (often called "steroids"). Other steroid drugs include hydrocortisone, methylprednisolone etc. Prednisolone can be given in different ways, including tablet, injection, and inhaled form. It is usually given as a tablet when used after a kidney transplant, or for certain kidney disorders. Steroid drugs, such as prednisone, work by lowering the activity of the immune system. The immune system is our body’s defense system. Steroids work by slowing our body’s response to disease or injury. Prednisone is used to treat many different diseases like: 1) Lupus 2) Asthma 3) Rashes 4) Certain types of arthritis. Prednisone can also be used to manage other kidney disorders, including: a) Focal glomerulosclerosis (FSGS) b) Minimal change disease (MCD) c) IgA nephropathy. Nephrotic Syndrome is a disease primarily of Pediatric age group. The syndrome is characterized by heavy proteinuria> 40mg/ m²/ h, hypoalbuminaemia< 2.5 gm /dl, edema and hyperlipidemia .1 Majority of affected children were steroid/prednisolone-sensitive minimal change disease. First-line drug for the treatment of idiopathic nephrotic syndrome is steroid/prednisolone therapy. 2 As hypoalbuminaemia is one of the cardinal features, measurement of serum albumin level is important.1 In children the most common presentation of glomerulonephritis is nephrotic syndrome. Histologically minimal change disease is the commonest 76.4%. 3 In a retrospective study of all children in Nelson R Mandela School of Medicine, the commonest cause of chronic kidney disease (stage 2-5) was Nephrotic Syndrome comprising 30.9% in children < 5 years old & 40.8% in > 5 years old.4 InNephrotic syndrome, renal failure may develop in some percentage. 30-40 % steroid resistant minimal change disease develops end stage renal disease by 5 years. 5 First-line drug in idiopathic nephrotic syndrome of childhood is prednisolone. The degree of therapeutic response and the side effects of prednisolone may show considerable inter individual variation