Growth in children with nephrotic syndrome: a post hoc analysis of the NEPTUNE study.

Document Type

Article

Publication Date

9-2024

Identifier

DOI: 10.1007/s00467-024-06375-9

Abstract

BACKGROUND: Steroids, the mainstay of treatment for nephrotic syndrome in children, have multiple adverse effects including growth suppression.

METHODS: Anthropometric measurements in children < 18 years enrolled in the Nephrotic Syndrome Study Network (NEPTUNE) were collected. The longitudinal association of medication exposure and nephrotic syndrome characteristics with height z-score and growth velocity was determined using adjusted Generalized Estimating Equation regression and linear regression.

RESULTS: A total of 318 children (57.2% males) with a baseline age of 7.64 ± 5.04 years were analyzed. The cumulative steroid dose was 216.4 (IQR 61.5, 652.7) mg/kg (N = 233). Overall, height z-scores were not significantly different at the last follow-up compared to baseline (- 0.13 ± 1.21 vs. - 0.23 ± 1.71, p = 0.21). In models adjusted for age, sex, and eGFR, greater cumulative steroid exposure (β - 7.5 × 10-6, CI - 1.2 × 10-5, - 3 × 10-6, p = 0.001) and incident cases of NS (vs. prevalent) (β - 1.1, CI - 2.22, - 0.11, p = 0.03) were significantly associated with lower height z-scores over time. Rituximab exposure was associated with higher height z-scores (β 0.16, CI 0.04, 0.29, p = 0.01) over time.

CONCLUSION: Steroid dose was associated with lower height z-score, while rituximab use was associated with higher height z-score.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

39

Issue

9

First Page

2691

Last Page

2701

MeSH Keywords

Humans; Nephrotic Syndrome; Male; Female; Child; Child, Preschool; Body Height; Adolescent; Growth Disorders; Longitudinal Studies; Glucocorticoids; Rituximab

Keywords

Body mass index (BMI); Height; Nephrotic syndrome; Steroids; Weight

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