الفهرس 
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Abstract
The study was aiming to investigate children with
nephrotic syndrome for the presence of liver affection clinically and/or biochemically.
It was conducted on a group of 100 patients with various types of childhood nephrotic syndrome clinically and laboratory diagnosed following up in the Pediatric Nephrology Clinic Children’s Hospital, Ain Shams University.
They were 67(67%) males and 33 (33%) females
with ages (42%) above 11 years.
Detailed history was taken from all patients including age, sex, duration of the disease, activity of the disease (relapse/remission), duration, dose, and response to steroid therapy, presence of symptoms of liver affection as screen patients with childhood nephrotic syndrome for liver affection and to investigate for its cause if present.
Careful examination of patients was done with special emphasis on manifestations of nephrotic syndrome (lower limb edema, puffy eye lids, ascites), complications of steroid therapy (cushinoid appearance, hypertension,….), and
symptoms suggestive of liver affection (presence of jaundice,liver examination, signs of portal hypertension and splenomegly…..).
TWe did some investigations for all patients as liver enzymes, and abdominal ultrasound, and some special investigation for patients with affected liver as lipid profile,hepatitis markers.
Data was collected, tabulated, and statistically
analyzed.
The results of study revealed that:
Male patients (67%) with nephrotic syndrome were predominant than females (33%).
Average age of onset ranges from1-15 years and the mean was 4.9, while average disease duration was 1.48 years. And systolic blood pressure (SBP) ranges from 80-120mmHg and mean was 103, also (DBP) diastolic blood pressure ranges from 50-90mmHg and mean was 67.
46% of the studied cases had a disease of more than 5 years and 12% recent cases less than 1year duration, with infrequent relapse in 52% of the studied cases, and 17% of them had no relapse. Frequent relapses in31% of cases.
13% of the studied cases had edema, and 23% of the studied cases had liver enlargement.
68% of the studied cases are treated by prednisone,while 17% of them treated by combined treatment.
All cases showed average liver enzymes ALT,
bilirubin and INR within the normal range for age.
Majority of cases with affected liver were above 11 years, while 6-10 years was the most frequent age in normal group with highly significant association between age and liver affection.
Cases with affected liver had higher anthropometric data in comparison to normal group with highly significant and significant difference respectively Cases with more frequent relapses had more hepatic affection in comparison to normal group with highly significant difference in between.
A statistically significant longer duration and more chronic disease found in patients more liver affection was found compared to normal group.
Patients had earlier onset of nephrotic syndrome had more affected liver so there is highly statistical significant difference found between the two groups.
On the other hand, there was no statistical significant difference between cases as regards; sex, blood pressure,type of treatment, lipid profile.
Frequent relapse and longer duration are considered the most important independent predictors for liver affection.
The independent predictors are lipid profile, hepatitis markers, treatment.