Study of the growth and puberty in Iraqi children with nephrotic syndrome


Background: Nephrotic syndrome is a chronic disease with frequent relapses and the accumulative dose of steroid play an important role in developing growth retardation.Aims: To detect the degree of growth retardation in long standing nephrotic syndrome and frequent relapsing nephrotic syndrome, and to identify the effect of nephrotic syndrome and steroid therapy on puberty.Patient and methods: A cross sectional study conducted in Child Central Teaching Hospital from the first of January to first of July 2008, on 108 patients with steroid responding nephrotic syndrome, 60 of them were males and 48 were females. All had anthropometric measurement of height and the assessment depend on Tanner growth centile for age and sex, so as the puberty staging according to Tanner staging. The ranges of the patients ages were 2-17y and the mean age was 11.5+4 y. 59.25% (64) were having steroid toxicity; no patient was on cytotoxic drug.Results: The results were shown that 52/ 108 (48.18%) of the patients have got growth retardation (2SD below the mean) Fifty of the patients were at pubertal age, 30 were males and 20 were females. 39 patients had delayed puberty (78%), 36 patients with delayed puberty had steroid toxicity (94.73%). There is a significant relationship between frequency of relapses, duration of illness and steroid toxicity with incidence of delayed puberty and growth retardation.Conclusions: There is a significant correlation between the growth retardation and the development of steroid toxicity. With frequent relapses and long standing nephrosis, there is a chance to develop growth retardation. Delayed puberty is more with steroid toxicity and it is more in males than females.