Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children

Esmeray Haluk; Emre Sevinç; Yılmaz Alev; Yavaş Aksu Bağdagül; Yürük Yıldırım Zeynep; Bilge Ilmay

doi:https://dx.doi.org/10.5222/j.child.2017.030

Research Article

DOI :10.5222/j.child.2017.030 IUP :10.5222/j.child.2017.030 Full Text (PDF)

Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children

Haluk Esmeray, Sevinç Emre, Alev Yılmaz, Bağdagül Yavaş Aksu, Zeynep Nagehan Yürük Yıldırım, Ilmay Bilge

Objective: The data reflecting adverse effects seen during the treatment of nephrotic syndrome (NS) in Turkey are limited. In this study, we aimed to evaluate the side effects of treatment of NS patients observed at our clinic. Material and Method: We retrospectively reviewed the data of 206 patients with NS (126 male; 80 female) followed up at the Pediatric Nephrology outpatient clinic of the Istanbul University Istanbul Medical Faculty between 1986-2010. Results: Mean age of 206 (126 male, 80 female) patients at the time of admission was 3.8±2.8 years (range: 0.2-13.8). During follow-up, 171 patients (83%) experienced at least one side effect due to any of the drugs. The most frequent side effects of steroid treatment in order of decreasing frequency were cushingoid appearance (52%), hypertension (23.4%), growth retardation (17%), cataract (6.8%) and osteoporosis (6.8%). Total duration of steroid use and steriod dose were higher in the patients who suffered from growth retardation, osteoporosis, cataract, hypertension than in those who did not suffer these side effects (p<0.05). Additionally, the patients with growth retardation had a higher relapse rate than in those without growth retardation (p=0.023). Neutropenia was detected in 13 (41.9%) patients who used cyclophosphamide, while in 5 (29.4%) patients who used cyclosporine A hypertension was observed. Conclusion: Adverse effects due to treatment of NS are seen in most of the patients with the diagnosis of nephrotic syndrome. The most serious adverse effects of steroids are growth retardation, osteoporosis, cataract and hypertension. These side effects were found to be related to duration of steroid treatment and total dose of steroids. Patients should be evaluated for these side effects periodically.

Keywords: Nephrotic syndrome, steroid therapy, steroidinduced side effect

DOI :10.5222/j.child.2017.030 IUP :10.5222/j.child.2017.030 Full Text (PDF)

Nefrotik Sendromlu Çocuklarda Tedavi Yan Etkilerinin Değerlendirilmesi

Haluk Esmeray, Sevinç Emre, Alev Yılmaz, Bağdagül Yavaş Aksu, Zeynep Nagehan Yürük Yıldırım, Ilmay Bilge

Amaç: Ülkemizde nefrotik sendrom (NS) tedavisi sırasında görülen yan etkilerin sıklığını yansıtan veriler yetersizdir. Bu çalışmada, kliniğimizde NS nedeniyle izlenen hastalarda ortaya çıkan tedavi yan etkilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: İstanbul Üniversitesi İstanbul Tıp Fakültesi Çocuk Nefrolojisi Bilim Dalı Polikliniğine 1986-2010 yılları arasında başvuran ve NS tanısı ile izleme alınan toplam 206 hastanın (126 erkek, 80 kız) poliklinik dosyaları incelenerek verileri geriye dönük olarak değerlendirildi. Bulgular: Çalışma grubuna alınan toplam 206 hastanın (126 erkek; 80 kız) başvuru sırasındaki yaş ortalaması 3,8±2,8 yıl (0.2-13.8 yıl) idi. İzlemde herhangi bir ilaca karşı hastaların 171’inde (%83) en az bir yan etki oluştu. Steroid tedavisinde görülen yan etkiler sırasıyla cushingoid görünüm gelişmesi (%52), hipertansiyon (%23.4), büyüme geriliği (%17), katarakt (%6.8) ve osteoporoz (%6.8) idi. Büyüme geriliği, osteoporoz, katarakt ve hipertansiyon saptanan hastalarda saptanmayan hastalara göre steroid tedavi süresi ve toplam steroid dozu anlamlı olarak yüksekti (p<0.05). Ayrıca büyüme geriliği saptanan hastalarda relaps sayısı büyüme geriliği saptanmayan hastalara göre anlamlı daha fazlaydı (p=0.023). Siklofosfamid kullanan 13 hastada (%41.9) nötropeni, siklosporin A kullanan 5 hastada (%29.4) hipertansiyon gözlendi. Sonuç: Nefrotik sendrom tanılı hastaların çoğunda tedaviye bağlı yan etkiler görülmektedir. Steroid kullanımı nedeniyle ortaya çıkan en ciddi yan etkiler büyüme geriliği, osteoporoz, katarakt ve hipertansiyondur. Bu yan etkilerin görülme oranı ile steroid tedavi süresi ve toplam steroid dozu arasında ilişkili bulunmuştur. Hastalar bu yan etkiler açısından belirli aralıklarla değerlendirilmelidir.

Keywords: Nefrotik sendrom, steroid tedavisi, steroide bağlı yan etkiler

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APA

Esmeray, H., Emre, S., Yılmaz, A., Yavaş Aksu, B., Yürük Yıldırım, Z.N., & Bilge, I. (0001). Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children. Journal of Child, 17(1), 30-35. https://doi.org/10.5222/j.child.2017.030

AMA

Esmeray H, Emre S, Yılmaz A, Yavaş Aksu B, Yürük Yıldırım Z N, Bilge I. Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children. Journal of Child. 0001;17(1):30-35. https://doi.org/10.5222/j.child.2017.030

ABNT

Esmeray, H.; Emre, S.; Yılmaz, A.; Yavaş Aksu, B.; Yürük Yıldırım, Z.N.; Bilge, I. Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children. Journal of Child, [Publisher Location], v. 17, n. 1, p. 30-35, 0001.

Chicago: Author-Date Style

Esmeray, Haluk, and Sevinç Emre and Alev Yılmaz and Bağdagül Yavaş Aksu and Zeynep Nagehan Yürük Yıldırım and Ilmay Bilge. 0001. “Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children.” Journal of Child 17, no. 1: 30-35. https://doi.org/10.5222/j.child.2017.030

Chicago: Humanities Style

Esmeray, Haluk, and Sevinç Emre and Alev Yılmaz and Bağdagül Yavaş Aksu and Zeynep Nagehan Yürük Yıldırım and Ilmay Bilge. “Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children.” Journal of Child 17, no. 1 (Nov. 2024): 30-35. https://doi.org/10.5222/j.child.2017.030

Harvard: Australian Style

Esmeray, H & Emre, S & Yılmaz, A & Yavaş Aksu, B & Yürük Yıldırım, ZN & Bilge, I 0001, 'Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children', Journal of Child, vol. 17, no. 1, pp. 30-35, viewed 25 Nov. 2024, https://doi.org/10.5222/j.child.2017.030

Harvard: Author-Date Style

Esmeray, H. and Emre, S. and Yılmaz, A. and Yavaş Aksu, B. and Yürük Yıldırım, Z.N. and Bilge, I. (0001) ‘Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children’, Journal of Child, 17(1), pp. 30-35. https://doi.org/10.5222/j.child.2017.030 (25 Nov. 2024).

MLA

Esmeray, Haluk, and Sevinç Emre and Alev Yılmaz and Bağdagül Yavaş Aksu and Zeynep Nagehan Yürük Yıldırım and Ilmay Bilge. “Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children.” Journal of Child, vol. 17, no. 1, 0001, pp. 30-35. [Database Container], https://doi.org/10.5222/j.child.2017.030

Vancouver

Esmeray H, Emre S, Yılmaz A, Yavaş Aksu B, Yürük Yıldırım ZN, Bilge I. Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children. Journal of Child [Internet]. 25 Nov. 2024 [cited 25 Nov. 2024];17(1):30-35. Available from: https://doi.org/10.5222/j.child.2017.030 doi: 10.5222/j.child.2017.030

ISNAD

Esmeray, Haluk - Emre, Sevinç - Yılmaz, Alev - Yavaş Aksu, Bağdagül - Yürük Yıldırım, ZeynepNagehan - Bilge, Ilmay. “Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children”. Journal of Child 17/1 (Nov. 2024): 30-35. https://doi.org/10.5222/j.child.2017.030

Volume 17, Issue 12017, P. 30-35

TIMELINE

Submitted	02.08.2016
Accepted	23.12.2016

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Journal of Child

Research Article

Evaluation of the Advers Effects of the Treatment of Nephrotic Syndrome in Children

Nefrotik Sendromlu Çocuklarda Tedavi Yan Etkilerinin Değerlendirilmesi

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