Vitamin D level in nephrotic syndrome, Factors of impact?

Document Type : Original Article


1 Kasr Al Ainy School of Medicine, Pediatric department, Cairo University, Cairo, Egypt

2 Kasr Al Ainy School of Medicine, Pediatric department, Cairo University, Cairo, Egypt.

3 Kasr Al Ainy School of Medicine, Clinical Pathology department, Cairo University, Cairo, Egypt.

4 Pediatrics department, Ministry of Health, Cairo, Egypt.


Nephrotic syndrome (NS) usually responds to steroid therapy; however, the majority of children relapse, resulting in prolonged and repeated courses of steroid therapy. Vitamin D is a vital component of bone metabolism and calcium homeostasis. Maintenance of adequate levels of vitamin D is recommended to maintain good bone health and other organ systems of NS patients. The study aimed to assess serum 25 (OH) D levels in children with NS, compare its level with healthy age and sex-matched controls and compare its level in different types of NS.
Patients and Methods
It was a cross-sectional study for measuring 25(OH) D levels in 60 patients with NS and 60 apparently healthy children, to be compared as controls. Nephrotic patients were classified as steroid sensitive (20 cases) steroid dependent (20cases), and steroid resistant (20 cases). Serum 25-hydroxyvitamin [25(OH) D] was measured using Enzyme Linked Immune 
Sorbent Assay (ELISA) technique.
Serum 25(OH) D was significantly lower in NS patients than control group (p<0.001).Steroid resistant nephrotic syndrome (SRNS) patient group showed the highest drop than the other 2 groups (p<0.001). There was significant negative correlation between vitamin D level and number of relapses, 24 hours urinary proteins and serum cholesterol.
It is recommended that NS patients especially on long term steroid therapy should undergo regular follow up of vitamin D level and early prophylactic supplementation with calcium and vitamin D should be advised.


Main Subjects