Assessment of serum RANKL in Children with Nephrotic Syndrome: Its Relation toGlucocorticoids Treatment

摘要

Nephrotic syndrome (NS) is considered as a common chronic disorder. Its prevalence in children is 15 times greater than adults. Receptor Activator of Nuclear Factor-Kappa B Ligand ( RANKL) is one of the proteins in the tumor necrosis factor (TNF)/TNF receptor families required for the control of bone remodeling. The aim of this study was to assess the serum level of RANKL in children with idiopathic nephrotic syndrome (INS) in different stages of the disease (remission & relapse) and its relation to glucocorticoids treatment. The study comprised 40 children diagnosed as having INS. Twenty children were in relapse and the other 20 were in remission. Another 20 healthy children served as control group who were matching in age and sex involved in the study. All the studied children were screened for their anthropometric measurements (height, weight, Body mass index (BMI) for-age Z-score), clinical parameters and laboratory assessment; (serum RANKL, albumin, cholesterol, A/C ratio, calcium, phosphorus, ALP, and creatinine). Results of this work revealed that sRANKL concentration was significantly higher in the relapse group as compared to the control group (p=0.002). No similar difference was noted between remission and control. In addition the results showed a significant positive correlation between the duration of glucocorticoids (GCS) treatment and the concentration of sRANKL in both groups of NS patients. It was concluded from this study that treatment with GCS for a long time results in bone affection, so sRANKL can be used as a detector of bone affection and abnormality and accordingly early intervention and prevention of complications can take place.