Electrolyte Imbalance in Steroid Sensitive and Steroid Resistant Pediatric Nephrotic Syndrome: A Case Control Study

Abstract

Background: Pediatric nephrotic syndrome can be divided into two broad categories based on steroid responsiveness, i.e., steroid-sensitive nephrotic syndrome (80-85%) and steroid-resistant nephrotic syndrome (10-15%) cases. It is accompanied by fluid and electrolyte imbalance. The serum levels of sodium (Na+), potassium (k+), calcium, (Ca+), albumin, urea, and creatinine in SSNS and SRNS children. Material and method: 38 children of age group 3-16 years, were included (30 SSNS and 8 SRNS) in this study. Independent t-tests were done for statistical analysis. Results: Reduced sodium level was noted in SRNS patients (p < 0.05), whereas potassium and creatinine were significantly high in SRNS (p < 0.01). No significant difference was noted in the level of calcium in these groups (p > 0.05). These results suggest hyponatremia and hyperkalemia as potential associations with steroid resistance. Conclusion: Hyponatremia was more pronounced in SRNS (p = 0.02), hyperkalemia was significantly elevated in SRNS (p = 0.01). Serum creatinine was elevated in SRNS (p = 0.003), indicating early renal function impairment and higher risk of CKD development. Hypocalcemia was not significant (p = 0.47). Albumin was significantly reduced in SRNS (p = 0.01), corroborating the association of proteinuria with the severity of steroid resistance.