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

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

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

Ueda, Yasuhiro; Okamoto, Takayuki; Sato, Yasuyuki et al.

Pediatric nephrology, 2023, 38(10), 3285-3296

Permalink : https://hdl.handle.net/2115/93497

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アクセス権	open access
URI	https://hdl.handle.net/2115/93497
タイトル	Changes in bone turnover markers after discontinuing long-term glucocorticoid administration in children with idiopathic nephrotic syndrome : a multicenter retrospective observational study
著者	Ueda, Yasuhiro ; Okamoto, Takayuki ; Sato, Yasuyuki ; Hayashi, Asako ; Takahashi, Toshiyuki ; Suzuki, Ryota ; Aoyagi, Hayato ; Ueno, Michihiko ; Kobayashi, Norio ; Uetake, Kimiaki ; Nakanishi, Masanori ; Ariga, Tadashi ; Manabe, Atsushi
著者名 Ueda, Yasuhiro
e-Rad_Researcher 70636349 著者名 Okamoto, Takayuki
著者名 Sato, Yasuyuki
著者名 Hayashi, Asako
著者名 Takahashi, Toshiyuki
著者名 Suzuki, Ryota
著者名 Aoyagi, Hayato
著者名 Ueno, Michihiko
著者名 Kobayashi, Norio
著者名 Uetake, Kimiaki
著者名 Nakanishi, Masanori
著者名 Ariga, Tadashi
e-Rad_Researcher 20292849 著者名 Manabe, Atsushi
言語	英語
キーワード	Bone turnover markers
	Children
	Glucocorticoid
	Nephrotic syndrome
	Rituximab
発行日	2023-10-01
出版者	Springer
収録物名	Pediatric nephrology
巻(号)	38(10)
ページ	3285-3296
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s00467-023-05966-2.
PISSN	0931-041X
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00467-023-05966-2