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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Change in Bone Mineral Density and Role of Vitamin D and Calcium Supplementation During Treatment of First Episode Nephrotic Syndrome SC18-SC21
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Change in Bone Mineral Density and Role of Vitamin D and Calcium Supplementation During Treatment of First Episode Nephrotic Syndrome SC18-SC21

机译：首发性肾病综合征SC18-SC21治疗期间骨矿物质密度的变化以及维生素D和钙的补充作用

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Introduction: Nephrotic Syndrome (NS) is one of the common illnesses in childhood. Oral glucocorticoids are mainstay of treatment, which are known to cause various short term and long term adverse effects including osteoporosis. Children with first episode and infrequent relapsing NS are not prescribed Calcium (Ca) and Vitamin D (VitD) supplements routinely.Aim: To observe change in Bone Mineral Density (BMD) in children during first episode of NS and role of VitD and Ca supplementation during the treatment of first episode of NS.Materials and Methods: A double blind randomized control trial was conducted in Department of Paediatrics at a tertiary care center in New Delhi, India, from October 2011 to March 2013. Three groups were made, each having sample size of 20. Group A (intervention group) consisted of first episode NS patients who received steroids along with VitD and Ca supplements. Group B (placebo group) had children with first episode of NS treated with steroids and placebo. Biochemical tests and BMD assessment were done at start and after three months of steroid treatment. Groupwise differences in BMD, VitD, Ca, Phosphate (PO4) and Alkaline Phosphatase (ALP) were assessed at baseline and after three months through Analysis Of Variance (ANOVA). Linear regression models for repeated measures were used to test the association between different variables and BMD and also between various study groups.Results: Among study population, Group B had significant decrease in VitD levels (28.85±5.52 ng/dl to 14.22±1.36 ng/dl) than to Group A (23.59±6.08 ng/dl to 13.27±1.35 ng/dl) after three months of steroid treatment. Similarly BMD decreased significantly in Group B (-0.033g/cm2) as compared to Group A (0.001g/cm2) showing significant decrease in VitD and BMD in children with first episode of NS after three months of steroid treatment whereas use of VitD and Ca supplements improves the deficit.Conclusion: Ca and VitD supplement should be used during treatment of first episode of NS, but further studies are required to ascertain the adequate dose for the same.
机译：简介：肾病综合症（NS）是儿童时期的常见疾病之一。口服糖皮质激素是治疗的中坚力量，已知会引起各种短期和长期不良反应，包括骨质疏松症。首发和复发性NS少见的儿童不定期服用钙（Ca）和维生素D（VitD）补充剂目的：观察首发NS期间儿童骨骼矿物质密度（BMD）的变化以及VitD和Ca补充剂的作用材料和方法：2011年10月至2013年3月，在印度新德里三级护理中心的儿科进行了一项双盲随机对照试验。分为三组，每组样本量为20。A组（干预组）由接受类固醇以及VitD和Ca补充剂的首发NS患者组成。 B组（安慰剂组）有首例NS患儿接受类固醇和安慰剂治疗。在类固醇治疗开始时和三个月后进行生化测试和BMD评估。在基线时和三个月后通过方差分析（ANOVA）评估BMD，VitD，Ca，磷酸盐（PO4）和碱性磷酸酶（ALP）的分组差异。结果：在研究人群中，B组的VitD水平显着下降（从28.85±5.52 ng / dl降至14.22±1.36 ng），用于重复测量的线性回归模型用于检验不同变量与BMD以及各个研究组之间的关联。 / dl）较之类固醇治疗三个月后的A组（23.59±6.08 ng / dl至13.27±1.35 ng / dl）。类似地，与A组（0.001g / cm2）相比，B组的BMD（-0.033g / cm2）显着下降，显示在类固醇治疗三个月后出现NS首次发作的儿童中，VitD和BMD显着下降，而使用VitD和钙补充剂可改善赤字。结论：钙和VitD补充剂应在NS的首发治疗中使用，但需要进一步研究以确定适当的剂量。

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