The Effects of Steroid Therapy on Bone and Eyes in Children with Nephrotic Syndrome

Objective: The aim of this study was to evaluate complications of long-term steroid usage on the eyes and bone metabolism, which can be detected at early stage, and to encourage the necessary precautions. Methods: This retrospective study was performed with data of patients who took steroid therapy for nephrotic syndrome and were followed up between June 2006-May 2011 at Necmettin Erbakan University. Results: Fifty-six patients were included in this study. The mean age of the patients was 4.22.3 years. The patients were examined in 3 groups according to steroid therapy. Group 1 was defined as patients who had not received steroids in the past year and who were in the remission stage, Group 2 comprised patients who had received steroids in the last year and who were in the remission stage, and Group 3 was made up of patients who were in the active nephrotic period and had received steroids. In terms of biochemical parameters (serum urea, creatinine, calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone, osteocalcin, vitamin D, triglycerides), there was no statistically significant difference between the 3 groups. Group 3 had a higher ratio of calcium/creatinine and protein/creatinine in spot urine than Groups 1 and 2. Of 56 patients, 40 patients had eye examinations. There was no statistically significant difference determined in terms of side effects of steroid treatment. Conclusion: Pediatricians should be very careful while following up the children who use steroids at a young age due to the possibility of cataract development and side effects on bone metabolism.