الفهرس 
Childhood Nephrotic SyndromeOnly 14 pages are availabe for public view
 |  | from | 103 |  |  |
| | | from | 103 | | |
Abstract
The study design was cas-control study which was conducted in the Nephrology Clinic, Children Hospital, Ain Shams University on 25 nephrotic patients following up at the pediatric nephrology clinic, and 10 age and sex matched healthy children as a control group.
They were classified into 3 groups :-
Group I:
Included 10 newly diagnosed nephrotic patients, 5males and 5 females. Their ages ranged from 4-10 years with mean age was 6.5+1.7 years.
Group II:
Included 15 nephrotic patients who were in relapse, before initiating steroid therapy, 9 males and 6 females, their ages ranged from 4-12 years with mean age was 8+2.3 years.
Control group (group III):
Included 10 age and sex matched healthy children. 6 males and 4 females, their ages ranged from 5- 12 years with mean age of 8.7+2.4 years.
The study revealed that serum concentrations of Lp(a), TC, TG, HDL-C, and LDL-C, were significantly higher in nephrotic patients than in the control group (p<0.001). This is attributed to enhancement of hepatic synthesis of serum lipids that may be stimulated by decrease serum albumin. Our results also demonstrated that there was nonsignificant difference (P>0.05) between the levels of TC, TG, HDL-C and LDL-C in new nephrotic patients when compared to their levels in relapse group.
In the present study, there was highly significant difference in plasma level of lipoprotein a {Lp (a)} between the studied groups where the plasma level of Lp(a) in children with nephrotic syndrome in relapse (group II) (243+83 mg/dl) was significantly higher than in newly diagnosed patients (131.9+56 mg/dl) and healthy controls (14+9.6 mg/dl) (P<0.001, P < 0.001 respectively).
The present study revealed that plasma level of serum albumin was lower in patients in relapse (2.2+0.16gm/dl) and newly diagnosed patients (2.2+0.21 gm/dl) in comparison to healthy controls (4.5+0.5gm/dl) due to loss of albumin in urine in nephrotic syndrome.
We found a highly significant (p<0.001) increase in 24h urinary protein excretion in patients in relapse (group II) (4330.67+107mg/24h) and new patient (group I) (4260+308.85 mg/24h) in comparison to healthy controls (group III) (77.8 +32.91 mg/24h).
In the current study Lp(a) in patients in relapse (group II) was significantly positively correlated with TC, TG and LDL (r=0.31, r=0.35, r=0.43 respectively, p<0.05).
In the current study, Lp(a) in plasma of nephrotic patients in relapse (group II) was highly significantly positively correlated with frequency of relapse (r=0.73, p<0.001) but there was not significantly correlated with other variables in this group (age, weight, height, body mass index, SBP, DBP, serum albumin, 24h Urinary protein and serum creatinine).
In our study There was no significant correlation between Lp (a) versus different variables among new cases (group I) (age, weight, height, body mass index, serum albumin, 24h Urinary protein, serum creatinine, DBP, SBP, serum creatinine, Cholesterol, TG, LDL and HDL).
The present study revealed that Lp (a) in plasma of relapse group was highly sensitive (94%) and highly specific (75%) than Lp(a) in new nephrotic children (90%, 40% respectively).
Finally, from this study we can conclude that the concentration of plasma Lp(a) in patients with relapse was higher than that in new patients and therefore plasma Lp(a) may serve as a marker for prediction of relapse.