الفهرس 
Nephrotic syndromeOnly 14 pages are availabe for public view
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Abstract
Introduction: Idioipathic nephrotic syndrome (INS) is the most common form of childhood nephrotic syndrome, the hallmark of the diseases still remains unknown, however; strong evidence suggests that it has an immune pathogenesis involving T-cells and its released cytokines including IFN-. Vitamin D is a multifunctional hormone that exerts its biological activities mainly through the vitamin D receptor (VDR) and has an anti-inflammatory and immunomodulatory effect on many immunological disorders.
Aims of the study: This study aimed at detecting the changes in serum level of vitamin D in children with idiopathic steroid sensitive nephrotic syndrome at diagnosis, early remission and at full remission together with studying the effect of vitamin D intake and other factors on achieving early remission and studying serum level of interferon gamma (IFN-) as a marker of immunoregulatory effect of vitamin D.
Subjects and methods: This study included twenty five newly diagnosed children with idiopathic steroid sensitive nephrotic syndrome and was randomly categorized into two groups; both received oral prednisolone at diagnosed; meanwhile, only group 2 received vitamin D injection. Vitamin D statuses were detected at initial diagnosis, early remission and at full remission together with the serum level of IFN -. Follow up was made over a period of 28 days.
Results: Study results revealed a deficiency of 25 (OH) D3 in our patients with INS, which improved markedly with remission especially if combined with vitamin D injection, while serum levels of 1, 25 (OH)2 D3 were normal from the start. Serum levels of IFN- were at lower levels which increased with remission; meanwhile its level did not increase significantly in vitamin D supplemented group. Dyslipidemia improved with vitamin D injection. Interestingly, the most determinant factor for achieving early remission was the younger of our patients at diagnosis.
In conclusion, deficiency of 25 (OH) D3 is common among children with INS and improves with remission which emphasizes the effect of proteinuria and loss of vitamin D binding protein on serum level of 25 (OH) D3. On the other hand, active vitamin D (1, 25 (OH)2 D3) does not seem to be affected. Vitamin D has no significant effect on serum IFN-g. Both vitamin D and IFN-g do not appear to have significant role in the immunopathogenesis of nephrotic syndrome. Screening for vitamin D deficiency in children with INS and administration of therapeutic doses of vitamin D will help remission. Vitamin D supplementation has a protective lowering effect on serum cholesterol.
Recommendation: Further studies on a wider scale and large number of the patients over long durations are recommended to study the exact role of vitamin D on immunopathogenesis of INS, possible renoprotective effects and to evaluate the function of T helper cells and their respective inflammatory cytokines among patients with INS. This will help to tailor specific treatment especially in case of steroid dependency or resistance.