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A comparative study of lipid profile in first attack versus relapse cases of idiopathic nephrotic syndrome in children

Manas Ranjan Upadhyay, Siba Shankar Beriha, Subal Kumar Pradhan

Abstract


Objectives: Nephrotic dyslipoprotenemia usually revert to normal with remission but hyperlipidemia is a well known risk factor of atherosclerosis and glomerular injury in children. There are few studies comparing the spectrum of dyslipidemia in initial attack and subsequent relapses of nephritic syndrome. The aim of the study was to compare the lipid profile in first attack and relapse cases of Idiopathic Nephrotic Syndrome in children. Methodology: The prospective study was conducted between May 2015-June 2017 at S.V.P.P.G.I and S.C.B Medical College, Cuttack. Total of 55 cases of Idiopathic Nephrotic Syndrome of aged 1 to 14 years were included in the study. Out of 55 cases 30 cases were in first attack and 25 cases were in the relapses group. The demographic data, lipid profile, magnitude of hyperlipidemia and serum albumin were analyzed in the study. Results: The total serum cholesterol level (470 + 116) mg/dl was higher in relapse cases as compared to first attack group. Similarly serum TG (305+115) mg/dl, LDL (354+126) mg/dl, VLDL (59+24) mg/dl level was higher in relapse cases. However serum HDL (41+8) mg/dl was found to be lower in relapse group as compared to first attack. The serum Albumin level (<2.5gm/dl) was low in all cases but in 12% cases (n=4) of relapse group was very low (<1.0 gm/dl). Conclusion: This establishes a higher serum cholesterol, TG, LDL, VLDL and marginally lower HDL level in relapse group as compared to first attack which may be explained by lower serum Albumin level causing higher lipid profile. This emphasis the need of close monitoring of lipid profile and in all further episode of relapse group for dietary modification and early intervention.

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Objectives: Nephrotic dyslipoprotenemia usually revert to normal with remission but hyperlipidemia is a well known risk factor of atherosclerosis and glomerular injury in children. There are few studies comparing the spectrum of dyslipidemia in initial attack and subsequent relapses of nephritic syndrome. The aim of the study was to compare the lipid profile in first attack and relapse cases of Idiopathic Nephrotic Syndrome in children. Methodology: The prospective study was conducted between May 2015-June 2017 at S.V.P.P.G.I and S.C.B Medical College, Cuttack. Total of 55 cases of Idiopathic Nephrotic Syndrome of aged 1 to 14 years were included in the study. Out of 55 cases 30 cases were in first attack and 25 cases were in the relapses group. The demographic data, lipid profile, magnitude of hyperlipidemia and serum albumin were analyzed in the study. Results: The total serum cholesterol level (470 + 116) mg/dl was higher in relapse cases as compared to first attack group. Similarly serum TG (305+115) mg/dl, LDL (354+126) mg/dl, VLDL (59+24) mg/dl level was higher in relapse cases. However serum HDL (41+8) mg/dl was found to be lower in relapse group as compared to first attack. The serum Albumin level (<2.5gm/dl) was low in all cases but in 12% cases (n=4) of relapse group was very low (<1.0 gm/dl). Conclusion: This establishes a higher serum cholesterol, TG, LDL, VLDL and marginally lower HDL level in relapse group as compared to first attack which may be explained by lower serum Albumin level causing higher lipid profile. This emphasis the need of close monitoring of lipid profile and in all further episode of relapse group for dietary modification and early intervention.


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