Content area
Full text
Introduction
Vitamin D plays an important role in maintaining physiological functions and can be considered vital components for bone health. It plays a crucial role in the homeostasis of calcium. Serum 25(OH)D level is considered stored form, and it reflects the adequacy of vitamin D level (> 30 ng/ml) [1, 2].
Recurrent relapses with proteinuria and remission is the characteristics feature of childhood NS. Approximately 60–80% of children relapse during course of illness. Steroids are the mainstay of treatment.More than 90% of patients respond to steroids and are maintained on remission with or without steroid-sparing drugs. Repeated high doses of steroids in children can lead to significant complications, including severe infections, growth retardation, obesity, osteoporosis, and disturbances in vitamin D and calcium levels [3].
NS has an influence on bone health due to disease process, and drug itself also plays an important role. Vitamin D deficiency in NS is associated with loss of both 25(OH)D and its binding protein in urine leading to deficiency [3, 4].
Children with NS usually have some calcium homeostasis problems and responsible for abnormal bone pathology, hypocalcaemia, reduced serum vitamin D metabolites, and impaired intestinal absorption of calcium and elevated levels of PTH. These are mainly influenced by the loss of some plasma proteins and minerals in the urine and also due to steroid therapy [5]. So prolonged and repeated use of steroids and disease itself increases the risk of vitamin D deficiency [5, 6].
All available epidemiological data indicate that vitamin D deficiency is common worldwide and its prevalence is very high. This deficiency has been emerged as significant health problem in all age groups [7]. It is estimated that 30 to 90% of the pediatric population, particularly those with chronic kidney disease and nephrotic syndrome, may experience a deficiency in vitamin D [6, 7–8].
A variety of studies showed prevalence of vitamin D deficiency were 80%, 71.7%, 66%, and 100% of the children, and this discrepancy is due to the difference in the cutoff values used to categorized vitamin D deficiency [9, 10–11].
Despite there being differences in vitamin D status in different regions and populations, to our knowledge, there is little data addressing vitamin D levels in children with NS from this sub-continents has been carried out....