Investigating Steroid-associated Peptic Symptoms in Patients With Primary Nephrotic Syndrome Steroid-associated Peptic Symptoms in Nephrotic Syndrome
Journal of Pediatric Nephrology,
Vol. 11 No. 3 (2023),
16 Mehr 2024
https://doi.org/10.22037/jpn.v11i3.43949
Abstract
Background and Aim: Nephrotic syndrome is the most common glomerulopathy among children
aged 2-10 years old and high doses of corticosteroids are the cornerstone of its management.
Whether corticosteroid use induces peptic ulcer disease in these patients remains uncertain. This
study explores any relation between steroids and peptic symptoms in these children.
Methods: A total of 100 nephrotic syndrome patients aged 1 to 15 years old treated with oral
prednisolone in our Outpatient Department were studied. In this study, we compared nephrotic
syndrome patients receiving 2 mg/kg prednisolone daily for 1 month and afterward as every
other day until tapering off in about 3-6 months. They were divided into groups. One received
aluminum Mg (Al-Mg) or proton pump inhibitors (PPIs) as prophylaxis and the other 50 patients
did not receive any prophylaxis. These two groups are investigated for any gastro-intestinal
complications. Heartburn, hematochezia, nausea, and dyspepsia are the four complications
that were studied.
Results: In this study, the data from 100 patients (61 male and 39 female) were analyzed.
Accordingly, 46% of the patients consumed 0.5 mg/kg prednisolone every other day and 19% of
the patients consumed 2 mg/kg prednisolone daily. In 51% of patients the duration of treatment
was more than 6 months and in 19% of cases it was less than a month. Also, among the 68%
of the patients who did not take PPIs, none experienced any digestive symptoms, including
hematochezia. Among those patients who received prophylactic, PPIs one patient with less
than a month of prednisolone taking and one who took prednisolone for more than six months
contracted hematochezia.
Conclusion: One-month therapy regimen of 2 mg/kg daily prednisolone and continuation
of it until tapering off the steroids causes few gastrointestinal symptoms. The use of PPIs or
Al-Mg did not affect the incidence of gastrointestinal symptoms significantly. Accordingly,
corticosteroid therapy does not increase peptic ulcers in nephrotic syndrome patients.
- Nephrotic syndrome
- pediatrics
- Peptic ulcer
How to Cite
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