الفهرس 
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Abstract
Nephrotic syndrome (NS) is one of the most common kidney diseases in pediatrics. NS presents in 15 to 20 per 100,000 children, with a remitting and relapsing character. Childhood steroid-sensitive nephrotic syndrome (SSNS) is a kidney disease, which promptly responds to high-dose steroid therapy. Unfortunately, the majority of children with SSNS relapse when the steroid dose is reduced, resulting in protracted, repeated courses of steroid. Bone loss caused by steroid therapy occurs due to activity of osteoblasts, the bone-forming cells, and increased bone resorption by osteoclasts, the bone-reabsorbing cells.
Steroid have also been found to promote osteoclastogenesis in several pediatric diseases that require long-term steroid treatment. The primary objective of the present study was to measure the levels of serum vitamin D, calcium, and phosphorus of children with nephrotic syndrome once the diagnosis is established and to measure levels of serum vitamin D, calcium, and phosphorus 6 weeks after starting steroid therapy.
We enrolled 50 patients with nephrotic syndrome in this study, 14 of whom were newly diagnosed and 36 of whom were relapsers. We measured and compared bone health markers (vitamin D, serum ionized calcium, serum phosphorus, and serum ALP) before and after corticosteroid administration. The average age of all individuals was estimated to be about 5 years, with relapsers being much older than freshly diagnosed subjects. It is worth noting that the average age of diagnosis for children in this research was about 4 years. In the relapsers group, the mean illness duration was 2.5 ±1.7 years.
In our study, the majority of subjects were infrequent relapsers (38%),