Plasma lipids as risk factors in relapsing nephrotic syndrome
Keywords:
nephrotic syndrome, hyperlipidemia, relapse, risk factors
Abstract
Background Nephrotic syndrome is primarily a pediatric disorderand is 15 times more common in children than in adults.
Relapse rate after corticosteroid discontinuation is 39 - 59%.
Hyperlipidemia is an important characteristic of nephrotic
syndrome. The plasma concentrations of cholesterol, triglyceride,
LDL, and VLDL are increased. Persistent hyperlipidemia after
remission can be found in frequent relapse nephrotic syndrome.
Objective To determine plasma lipids as risk factor for relapsing
nephrotic syndrome.
Methods Thirty children with nephrotic syndrome were included
in this cohort study from March 2005 until June 2007 at Wahidin
Sudirohusodo Hospital, Makassar. Thirty children without renal disease
were enrolled as control. Blood specimens were collected to determine
plasma lipids (cholesterol, triglyceride, LDL, and HDL) levels and LDU
HDL ratio. Plasma lipids were examined in the acute and remission
phases. Follow up was carried out six months after remission to
determine the occurrence of relapsing nephrotic syndrome.
Results Of 30 nephrotic syndrome patients, 12 had relapsed.
There were highly significant differences in total cholesterol, HDL,
LDL, triglyceride, and LDL/HDL ratio between acute nephrotic
syndrome and nephrotic syndrome in remission. There were no
significant differences in cholesterol, LDL, triglyceride, LDL!
HDL ratio between nephrotic syndrome in remission and control.
There was also no significant difference in the incidence in relapse
between first attack and nephrotic syndrome with more than two
attacks. Acute lipid fraction levels were not risk factors in relapsing
mephrotic syndrome. Remission triglyceride level was a risk factor
in relapsing nephrotic syndrome with the prevalence risk of 5.2 and
CI 95% of 1.06 to 25.3.
Conclusion Persistent hypertriglyceride in remission phase is
associated with an increased risk of relapse in children with
nephrotic syndrome.
References
1. Rauf S. Sindrom nefrotik. Lecturer's note of Division of
Nephrology, Departement of Child Health, Medical School,
Hasanuddin University. Makassar: Departement of Child
Health, Medical School, Hasanuddin University, 2002; p.
21-31.
2. Rauf S. Recent advances in treatment of nephrotic syndrome.
Proceeding of the Recent Advance Treatment Conference;
2005 January 8; Makassar, Indonesia.
3. Mitch WE, Klahr S. Management of lipid abnormalities in
patients with renal disease. In: Mitch WE, Klahr S, editors.
Handbook of nutrition and the kidney. 4th ed. Philadelphia:
Lippincott, 2003; p. 126-32.
4. Thabet HEAM, Salcedo RJ, Chan, J. Hyperlipidemia
in childhood nephrotic syndrome. Pediatr Nephrol.
1993:559-66.
5. Mandor H. Role of lipoprotein bound NEFAs in enhancing
the specific activity of plasma CETP in nephrotic syndrome.
Available from: uri: http://www. atub.ahajournals.org.
6. Zilleruelo G, Hsia L, Freundlich M, Gorman HM,
Strauss J. Persistence of serum lipid abnormalities in
children with idiopathic nephrotic syndrome. J Pediatr.
1984;104:61-4.
7. Rose BD, Appel GB. Hyperlipidemia in chronic kidney
disease. Available from: uri: http: //www.update.com.
8. Appel GB. Improved outcome in nephrotic syndrome. Clin
J Med. 2006;73:161-7.
9. Alatas H. Terapi mutakhir dan prognosis sindrom nefrotik
dependen dan resisten steroid. Proceedings of the 9th
Pediatric National Congress; 1983; Semarang, Indonesia.
10. Herijanto M. Kadar albumin dan kolesterol pada penderita
sindrom nefrotik serangan dan remisi [thesis]. Makassar:
Hasanuddin University; 2000.
11. Sekarwana N. The differences of lipid profile based on the
types of nephrotic syndrome in children and their relationship
between lipid profile, Lp(a) with sVCAM-1 as a marker
of atherosclerosis [dissertation]. Bandung: Padjajaran
University; 2005.
Nephrology, Departement of Child Health, Medical School,
Hasanuddin University. Makassar: Departement of Child
Health, Medical School, Hasanuddin University, 2002; p.
21-31.
2. Rauf S. Recent advances in treatment of nephrotic syndrome.
Proceeding of the Recent Advance Treatment Conference;
2005 January 8; Makassar, Indonesia.
3. Mitch WE, Klahr S. Management of lipid abnormalities in
patients with renal disease. In: Mitch WE, Klahr S, editors.
Handbook of nutrition and the kidney. 4th ed. Philadelphia:
Lippincott, 2003; p. 126-32.
4. Thabet HEAM, Salcedo RJ, Chan, J. Hyperlipidemia
in childhood nephrotic syndrome. Pediatr Nephrol.
1993:559-66.
5. Mandor H. Role of lipoprotein bound NEFAs in enhancing
the specific activity of plasma CETP in nephrotic syndrome.
Available from: uri: http://www. atub.ahajournals.org.
6. Zilleruelo G, Hsia L, Freundlich M, Gorman HM,
Strauss J. Persistence of serum lipid abnormalities in
children with idiopathic nephrotic syndrome. J Pediatr.
1984;104:61-4.
7. Rose BD, Appel GB. Hyperlipidemia in chronic kidney
disease. Available from: uri: http: //www.update.com.
8. Appel GB. Improved outcome in nephrotic syndrome. Clin
J Med. 2006;73:161-7.
9. Alatas H. Terapi mutakhir dan prognosis sindrom nefrotik
dependen dan resisten steroid. Proceedings of the 9th
Pediatric National Congress; 1983; Semarang, Indonesia.
10. Herijanto M. Kadar albumin dan kolesterol pada penderita
sindrom nefrotik serangan dan remisi [thesis]. Makassar:
Hasanuddin University; 2000.
11. Sekarwana N. The differences of lipid profile based on the
types of nephrotic syndrome in children and their relationship
between lipid profile, Lp(a) with sVCAM-1 as a marker
of atherosclerosis [dissertation]. Bandung: Padjajaran
University; 2005.
Published
2016-09-15
How to Cite
1.
Lawang S, Rauf S, Lisal J, Albar H, Daud D. Plasma lipids as risk factors in relapsing nephrotic syndrome. PI [Internet]. 15Sep.2016 [cited 23Dec.2024];48(6):322-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/621
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2016-09-14
Accepted 2016-09-14
Published 2016-09-15
Accepted 2016-09-14
Published 2016-09-15
