Clin Osteol 2009; 14(2): 58-62

Bone metabolism disorders in children with nephrotic syndromeReview articles

J. Feber, P. Geier

The article deals with the adverse effects that glucocorticoid therapy has on the bones of children with nephrotic syndrome. Special attention is paid to growth disorders, alterations in bone density and pathological fractures in this population. Glucocorticoids nega­ tively affect bone metabolism, in particular by suppressing bone formation and affecting the activity of osteoclasts. This was better un­ derstood by studying the osteoprotegerin (OPG)/RANK-ligand/RANK triad. Through inhibition of OPG and subsequent stimulation of RANK-L expression in osteoblasts, glucocorticoids stimulate osteoclastogenesis. The available literary data suggest that bone me­ tabolism disorders pose a threat especially to patients with steroid-dependent and steroid resistant nephrotic syndrome, requiring repeated/long-term corticoid therapy. Potential ways of reducing the adverse effects of glucocorticoid therapy for nephrotic syndrome are discussed, such as steroid-sparing regimens and treatment with vitamin D, calcium, biphosphonates and calcitonin.

Keywords: bone density, growth, corticoids, nephrotic syndrome, children

Published: December 11, 2009  Show citation

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Feber J, Geier P. Bone metabolism disorders in children with nephrotic syndrome. Osteologický bulletin. 2009;14(2):58-62.
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