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13-04-2023 | Glucocorticoid | Original Article

Changes in bone turnover markers after discontinuing long-term glucocorticoid administration in children with idiopathic nephrotic syndrome: a multicenter retrospective observational study

Authors: Yasuhiro Ueda, Takayuki Okamoto, Yasuyuki Sato, Asako Hayashi, Toshiyuki Takahashi, Ryota Suzuki, Hayato Aoyagi, Michihiko Ueno, Norio Kobayashi, Kimiaki Uetake, Masanori Nakanishi, Tadashi Ariga, Atsushi Manabe

Published in: Pediatric Nephrology | Issue 10/2023

Abstract

Background

Glucocorticoids affect bone turnover. Little is known about how bone turnover changes when glucocorticoids are discontinued following long-term administration.

Methods

This retrospective observational study was conducted on the relationship between discontinuation of long-term administration of glucocorticoid and bone turnover markers (BTMs) in patients with childhood-onset idiopathic nephrotic syndrome. Serum bone alkaline phosphatase (BAP), intact procollagen type 1 N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase-5b (TRACP-5b) were evaluated as BTMs.

Results

Thirty-eight pairs of BTMs at glucocorticoid administration and after discontinuation were analyzed in 29 patients. The median age at baseline was 12.4 (interquartile range, 9.0–14.5) years, and the median time from the onset of nephrotic syndrome was 5.9 (3.3–9.7) years. The mean period from prednisolone discontinuation to the measurement of BTMs after glucocorticoid discontinuation was 3.5 ± 1.0 months. Changes in BTMs after glucocorticoid discontinuation were modest when the daily prednisolone dose was < 0.25 mg/kg/day (ln BAP standard deviation [SD] score, p = 0.19; log intact P1NP SD score, p = 0.70; TRACP-5b, p = 0.95). When the daily prednisolone dose was ≥ 0.25 mg/kg/day, all BTMs increased significantly after glucocorticoid discontinuation (ln BAP SD score, p < 0.01; log intact P1NP SD score, p < 0.01; TRACP-5b, p < 0.01).

Conclusions

Decreased BTMs can rise within a few months of discontinuing long-term glucocorticoid administration. When the administered glucocorticoid dose is low, changes in BTMs may be small.

Graphical abstract

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Title: Changes in bone turnover markers after discontinuing long-term glucocorticoid administration in children with idiopathic nephrotic syndrome: a multicenter retrospective observational study
Authors: Yasuhiro Ueda
Takayuki Okamoto
Yasuyuki Sato
Asako Hayashi
Toshiyuki Takahashi
Ryota Suzuki
Hayato Aoyagi
Michihiko Ueno
Norio Kobayashi
Kimiaki Uetake
Masanori Nakanishi
Tadashi Ariga
Atsushi Manabe
Publication date: 13-04-2023
Publisher: Springer Berlin Heidelberg
Keywords: Glucocorticoid
Rituximab
Nephrotic Syndrome
Rituximab
Prednisolone
Published in: Pediatric Nephrology / Issue 10/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-023-05966-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in bone turnover markers after discontinuing long-term glucocorticoid administration in children with idiopathic nephrotic syndrome: a multicenter retrospective observational study

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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