Hyperlipidemia is a common finding in nephrotic syndrome. There is increased total Cholesterol, LDL, VLDL and low or normal HDL. Hyperlipidemia is usually observed during the active phase of disease and disappears with resolution of proteinuria. But in relapsing cases, it may persist and may increase risk of atherosclerosis in later life. Hence serial monitoring of lipids is required to predict prognosis. Hence, our study is an attempt to know derangement of serum lipids in nephrotic syndrome.
Methods: A prospective study included 30 children with nephrotic syndrome, aged between 0-12 years. They were clinically examined and lipid profile was done in each case before steroid therapy, after one month of therapy and at the end of therapy.10 children without liver and kidney disorders were taken as controls.
Results: In all cases, there were increased mean total cholesterol, LDl, VLDL and triglyceride. However there was no significant change in HDL. With steroid treatment, in first episode nephrotic syndrome, there was highly significant reduction in the mean levels of pretreatment total cholesterol, LDL (p= 0.001) and triglycerides (p= 0.016). However in relapse nephrotic syndrome, even at end of treatment, serum lipids were found to be persistently high.
Conclusion: Our study concludes that, there is generalized hyperlipidemia (except HDL) and hypoalbuminemia. The serum cholesterol level in first episode nephrotic syndrome reaches normal at the end of steroid therapy. But in cases of relapse, there is persistent elevation in the cholesterol levels, which may predispose to development of atherosclerosis and progression to chronic renal failure.