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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objectives To evaluate fibroblast growth factor-23 (FGF-23) levels in children with nephrotic syndrome treated with glucocorticosteroids in comparison with existing markers of bone metabolism. Background Nephrotic syndrome is a frequent chronic illness defined by changes of permselectivity at the capillary wall of renal glomeruli, resulting in the glomerular inability to limit protein loss in urine. FGF-23 is an effective phosphaturic hormone secreted by osteocytes, which has a vital role in vitamin D and phosphate homeostasis. Patients and methods This case–control study included 80 children of which 40 children with idiopathic nephrotic syndrome were subdivided into three groups: steroid-dependent, steroid-resistant, and frequent relapse, as well as 40 children as the control group. Venous blood samples were taken for estimation of serum phosphorus, calcium, and parathormone hormone (PTH). The level of FGF-23 was assayed by enzyme-linked immunosorbent assay. Correlations of FGF-23 level with serum calcium, phosphorus, and PTH were also investigated. Results Serum levels of calcium, phosphorus, and PTH for children in steroid-dependent, steroid-resistant, and frequent-relapse groups were significantly lower than the controls (P < 0.001). Serum levels of FGF-23 were significantly higher in steroid-dependent, steroid-resistant, and frequent-relapse groups with a mean of 5.16, 5, and 4.51 ng/l, respectively, compared with the control group with a mean of 0.48 ng/l (P < 0.001). There was a significant negative correlation between FGF-23 and each of PTH, phosphorus, and calcium (P < 0.05). Conclusion FGF-23 could be used as a biomarker for osteodystrophy in nephrotic kidney disease in children.

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