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Growth in boys with idiopathic nephrotic syndrome on long-term cyclosporin and steroid treatment

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Abstract

Although steroid-free remission can usually be achieved with cyclosporin A (CsA) in patients with steroid-dependent nephrotic syndrome (SDNS), some CsA-treated patients require long-term steroid therapy. Data on growth in these patients are scarce. Sixty-four boys with SDNS receiving long-term CsA and steroid therapy were retrospectively analyzed. During the 10-year follow-up period, height standard deviation score (HSDS) remained in the normal range in 47 patients but was below −2 SD in 17 patients. The occurrence of growth retardation was influenced by height at diagnosis and the number of relapses. Thirty patients were followed for at least 3 years before and after age 12. The decrease in HSDS per year of disease in patients older than 12 years was twice that observed in children younger than 12. However, adult height was ≤ −2 SD in only two of the 14 patients reaching adult height, reflecting potential catch-up growth during late puberty. Careful monitoring of growth is recommended, given than up to 25% of patients experienced severe growth retardation during the course of their disease.

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Acknowledgments

The authors thank all the attending physicians for providing data, and J.F. Hartmann, M.D., for invaluable assistance with the manuscript preparation.

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Authors and Affiliations

  1. Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Service de Néphrologie Pédiatrique, Paris, France

    Valérie Leroy, Véronique Baudouin, Chantal Loirat & Georges Deschenes

  2. Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Service de Biostatistiques et Santé Publique, Paris, France

    Corinne Alberti

  3. Université Paris 7, Faculté de Médecine Denis Diderot, INSERM, CIE5, Paris, France

    Corinne Alberti

  4. Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de Néphrologie Pédiatrique, Paris, France

    Geneviève Guest & Patrick Niaudet

  5. Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie-Diabétologie Pédiatrique, Paris, France

    Paul Czernichow & Dominique Simon

  6. Service de Néphrologie, Hôpital Robert Debré, 48 boulevard Sérurier, 75019, Paris, France

    Valérie Leroy

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  1. Valérie Leroy
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  2. Véronique Baudouin
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Correspondence to Valérie Leroy.

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Leroy, V., Baudouin, V., Alberti, C. et al. Growth in boys with idiopathic nephrotic syndrome on long-term cyclosporin and steroid treatment. Pediatr Nephrol 24, 2393–2400 (2009). https://doi.org/10.1007/s00467-009-1266-y

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  • DOI: https://doi.org/10.1007/s00467-009-1266-y

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