OBJECTIVE: To assess growth and body composition in children and adolescents with steroid-dependent nephrotic syndrome (SDNS). METHODS: All children aged 5 to 18 years diagnosed with SDNS and followed up at the Pediatric Nephrology Unit for at least two years were studied. The following data were collected from the medical records: duration of treatment; age at treatment onset; total dose of steroids (mg/ kg and mg/kg/d); weight and height at the first visit; and the albuminemia, total proteinemia, and total cholesterol values. The anthropometric measures (triceps and subscapular skinfold thickness, body mass index, arm muscle circumference, waist circumference, and height/age z-score) were routinely determined when patients had no clinical edema. Nonparametric statistics was used with significance level of p < 0.05. RESULTS: The study comprised 18 patients (11 males), aged 6 to 16 years (mean age, 12.22 ± 2.98), with a mean treatment duration of 6.75 ± 3.75 years. The initial height/ age z-score values were significantly greater than the final ones (-0.69 ± 0.80 and -2.07 ± 1.61, respectively; p = 0.003). Considering the individual evolution, height/age z-score decreased in 14 patients (-1.37 ± 1.55) and remained stable in four patients. Considering several parameters that could account for the difference in evolution, only residual proteinuria was significantly different. The arm muscle circumference was significantly smaller in the group with z-score decrease. CONCLUSION: Most patients had a deficit in height and a decrease in lean mass, probably associated with the severity of the nephrotic syndrome, which required high and prolonged corticosteroid doses.
nephrotic syndrome; growth; childhood; adolescence; corticosteroids; body composition
