Plasma Lipid Profile - Prognostic Factor in Nephrotic Syndrome – A Prospective Study

Abstract

Background: Nephrotic Syndrome is one of the most common glomerular disorders of childhood. Relapse rate after steroid discontinuation is 39-59%. Hyperlipidemia is one of the cardinal features in patients with Nephrotic Syndrome. Cases with increased serum levels of cholesterol and LDL have also been reported even after months or years in remission. The persistent hyperlipidemia correlates well with the duration and frequency of the relapses, even during the remission. Aim: To study the correlation between remission phase hyperlipidemia and subsequent relapse in Nephrotic Syndrome. Methods: Sixty five children were included in this cohort study at Kanyakumari Medical College & Hospital, Asaripallam. Fasting lipid profile is estimated at the acute phase of Nephrotic Syndrome before starting steroid therapy and 10 weeks after remission. They were followed up for six months from the time of remission to determine the occurrence of relapse. Results: Among the 60 included patients, 22 cases had their first episodes and 38 were infrequent relapse. Persistent hypercholesterolemia was observed in ten cases, out of which, seven cases developed relapse. Also, persistent hypertriglyceridemia was seen in 34 cases, out of which, 19 cases developed relapse. However, in the remission phase, hypercholesterolemia (chi sq= 5.090, p=0.024) and hypertriglyceridemia (chi sq= 10.22, p=0.001) were significantly associated with relapse. Conclusion: The role of dietary management and anti-triglyceridemic drugs to prevent progressive renal injury and subsequent relapse in this subgroup of patients' needs to be evaluated.

Comprassion the Lipid Profile among Children Suffreing from Nephrotic Syndrome before and after Remission

“…They came to the conclusion that serum cholesterol levels might be used to predict relapse in idiopathic nephrotic syndrome in children [18]. Our triglyceride levels were equivalent to those found in a study by Sitti Aizah Lawang et al (p0.035) [19,1,2,3]. However, there was no discernible difference in LDL and HDL levels.…”

“…Hippocrates' was the first to notice that "when bubbles settle on the surface of urine, they signal kidney disease." The nephrotic syndrome is a group of diseases that affect the kidneys [1][2][3][4][5]. Heavy proteinuria and hypoalbuminemia, as well as edema, hypercholesterolemia, and wide spread hyperlipidemia, characterize this clinical condition.…”