Publication:

Comparative study of lipid profile abnormalities in first episode and relapse cases of childhood nephrotic syndrome

Background Nephrotic syndrome (NS) is an important chronic renal disease in children, characterized by minimal change disease in the majority of cases. The objective was to study the levels of serum cholesterol, serum triglycerides, LDL VLDL and HDL in nephrotic syndrome at the onset and during remission in first episode and relapse cases.

Methods A prospective study which included 50 children with steroid sensitive nephrotic syndrome, aged between 2-12 years. Out of which 35 children were presented as first episode, and 15 children as relapse cases. They were clinically examined and lipid profile was done at the onset and during remission. 30 age matched controls without liver and kidney disorders were taken as controls.

Results There was statistically significant increase in serum cholesterol, triglycerides, LDL and VLDL in nephrotic syndrome patients when compared to controls (P ≤0.005), but HDL value was not significant (P = 0.234). In first episode of nephrotic syndrome cases serum lipids decreased significantly during remission, but HDL was increased during remission and it was not statistically significant, whereas in relapse cases even during remission serum lipids were significantly higher but HDL increase was not statistically significant. There was an inverse correlation between albumin and cholesterol. The correlation was statistically highly significant (P = 0.000).

Conclusions The present study shows that in nephrotic syndrome, there is generalized hyperlipidemia (except HDL). This was significantly higher in relapse cases compared to first episode. Lipid profiles reaches normal during remission in first episode, whereas in relapse cases it was significantly higher even during remission. Hence there is a rationale for treatment.