Glucose metabolism disorders in children with refractory nephrotic syndrome

Takahashi, Toshiyuki; Okamoto, Takayuki; Sato, Yasuyuki; Hayashi, Asako; Ueda, Yasuhiro; Ariga, Tadashi

Glucose metabolism disorders in children with refractory nephrotic syndrome

Takahashi, Toshiyuki; Okamoto, Takayuki; Sato, Yasuyuki et al.

Pediatric nephrology, 2020, 35, 649-657

Permalink : https://hdl.handle.net/2115/80861

このアイテムのアクセス数:557件（2026-08-26 23:30 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/80861
タイトル	Glucose metabolism disorders in children with refractory nephrotic syndrome
著者	Takahashi, Toshiyuki ; Okamoto, Takayuki ; Sato, Yasuyuki ; Hayashi, Asako ; Ueda, Yasuhiro ; Ariga, Tadashi
著者名 Takahashi, Toshiyuki
e-Rad_Researcher 70636349 著者名 Okamoto, Takayuki
著者名 Sato, Yasuyuki
著者名 Hayashi, Asako
著者名 Ueda, Yasuhiro
e-Rad_Researcher 60322806 著者名 Ariga, Tadashi
言語	英語
キーワード	Glucose metabolism disorders
	Oral glucose tolerance test
	Nephrotic syndrome
	Glucocorticoids
	Calcineurin inhibitors
発行日	2020-04
出版者	Springer
収録物名	Pediatric nephrology
巻(号)	35
ページ	649-657
抄録	Background Patients with refractory nephrotic syndrome (NS) are at high risk of medication-induced glucose metabolism disorders, because of their long-term use of diabetogenic medications, particularly glucocorticoids and calcineurin inhibitors (CNIs). However, there have been no comprehensive evaluations of glucose metabolism disorders in pediatric patients with refractory NS. Moreover, glucocorticoids and CNIs could not be discontinued in these patients until the effectiveness of rituximab on refractory NS was shown, and therefore, there has been limited opportunity to evaluate glucose metabolism disorders after discontinuation of these medications. Methods Consecutive pediatric patients who started rituximab treatment for refractory NS were enrolled. Their glucose metabolism conditions were evaluated using the oral glucose tolerance tests (OGTT) and HbA1c levels at the initiation of rituximab treatment. Patients with glucose metabolism disorders at the first evaluation were reevaluated after approximately 2 years. Results Overall, 57% (20/35) of study patients had glucose metabolism disorders, and 40% (8/20) of these patients were detected only by their 2-h OGTT blood glucose levels and not by their fasting blood glucose or HbA1c levels. Non-obese/non-overweight patients had significantly more glucose metabolism disorders than obese/overweight patients (p = 0.019). In addition, glucose metabolism disorders in 71% (10/14) of patients persisted after the discontinuation of glucocorticoids and CNIs. Conclusions Whether the patient is obese/overweight or not, patients with refractory NS are at high risk of developing glucose metabolism disorders, even in childhood. Non-obese/non-overweight patients who are at high risk of diabetes need extra vigilance.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This is a post-peer-review, pre-copyedit version of an article published in Pediatric Nephrology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00467-019-04360-1
PISSN	0931-041X
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00467-019-04360-1