Skip to main content
Erschienen in:

19.07.2017 | Original Article

The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome

verfasst von: Sushmita Banerjee, Surupa Basu, Ananda Sen, Jayati Sengupta

Erschienen in: Pediatric Nephrology | Ausgabe 11/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Low serum levels of total 25-hydroxycholecalciferol (25(OH)D) occur in nephrotic syndrome (NS). We aimed to assess the effects of vitamin D3 and calcium supplementation on 25(OH)D levels, bone mineralization, and NS relapse rate in children with steroid-sensitive NS.

Methods

A randomized controlled trial (RCT) was performed in children with steroid-sensitive NS. The treatment group received vitamin D3 (60,000 IU orally, weekly for 4 weeks) and calcium supplements (500 to 1,000 mg/day for 3 months) after achieving NS remission. Blood samples for bone biochemistry were taken during relapse (T0), after 6 weeks (T1) and 6 months (T2) of randomization, whereas a lumbar DXA scan was performed at T0 and T2. Renal ultrasound was performed after study completion in the treatment group and in all patients with hypercalciuria.

Results

Of the 48 initial recruits, 43 patients completed the study. Post-intervention, 25(OH)D levels showed significant improvements in the treatment group compared with controls at T1 (p < 0.001) and T2 (p < 0.001). However, this was not associated with differences in bone mineral content (BMC) (p = 0.44) or bone mineral density (BMD) (p = 0.64) between the groups. Additionally, there was no reduction in relapse number in treated patients (p = 0.54). Documented hypercalciuria occurred in 52% of patients in the treatment group, but was not associated with nephrocalcinosis.

Conclusions

Although supplementation with calcium and vitamin D improved 25(OH)D levels significantly, there was no effect on BMC, BMD or relapse rate over a 6-month follow-up. Occurrence of hypercalciuria mandates caution and appropriate monitoring if using such therapy. Appropriate dosage of vitamin D3 remains uncertain and studies examining biologically active vitamin D may provide answers.
Literatur
1.
Zurück zum Zitat Bak M, Serdaroglu E, Guclu R (2006) Prophylactic calcium and vitamin D treatments in steroid-treated children with nephrotic syndrome. Pediatr Nephrol 21:350–354CrossRefPubMed Bak M, Serdaroglu E, Guclu R (2006) Prophylactic calcium and vitamin D treatments in steroid-treated children with nephrotic syndrome. Pediatr Nephrol 21:350–354CrossRefPubMed
2.
Zurück zum Zitat Koşan C, Ayar G, Orbak Z (2012) Effects of steroid treatment on bone mineral metabolism in children with glucocorticoid-sensitive nephrotic syndrome. West Indian Med J 61:627–630PubMed Koşan C, Ayar G, Orbak Z (2012) Effects of steroid treatment on bone mineral metabolism in children with glucocorticoid-sensitive nephrotic syndrome. West Indian Med J 61:627–630PubMed
3.
Zurück zum Zitat El-Mashad GM, El-Hawy MA, El-Hefnawy SM, Mohamed SM (2017) Bone mineral density in children with idiopathic nephrotic syndrome. J Pediatr 93:142–147CrossRef El-Mashad GM, El-Hawy MA, El-Hefnawy SM, Mohamed SM (2017) Bone mineral density in children with idiopathic nephrotic syndrome. J Pediatr 93:142–147CrossRef
4.
Zurück zum Zitat Gulati S, Godbole M, Singh U, Gulati K, Srivastava A (2003) Are children with idiopathic nephrotic syndrome at risk for metabolic bone disease. Am J Kidney Dis 41:1163–1169CrossRefPubMed Gulati S, Godbole M, Singh U, Gulati K, Srivastava A (2003) Are children with idiopathic nephrotic syndrome at risk for metabolic bone disease. Am J Kidney Dis 41:1163–1169CrossRefPubMed
5.
Zurück zum Zitat Lettgen B, Jeken C, Reiners C (1994) Influence of steroid medication on bone mineral density in children with nephrotic syndrome. Pediatr Nephrol 8:667–670CrossRefPubMed Lettgen B, Jeken C, Reiners C (1994) Influence of steroid medication on bone mineral density in children with nephrotic syndrome. Pediatr Nephrol 8:667–670CrossRefPubMed
6.
Zurück zum Zitat Ribeiro D, Zawadynski S, Pittet LF, Chevalley T, Girardin E, Parvex P (2015) Effect of glucocorticoids on growth and bone mineral density in children with nephrotic syndrome. Eur J Pediatr 174:911–917CrossRefPubMed Ribeiro D, Zawadynski S, Pittet LF, Chevalley T, Girardin E, Parvex P (2015) Effect of glucocorticoids on growth and bone mineral density in children with nephrotic syndrome. Eur J Pediatr 174:911–917CrossRefPubMed
7.
Zurück zum Zitat Grymonprez A, Proesmans W, Van Dyck M, Jans I, Goos G, Bouillon R (1995) Vitamin D metabolites in childhood nephrotic syndrome. Pediatr Nephrol 9:278–281CrossRefPubMed Grymonprez A, Proesmans W, Van Dyck M, Jans I, Goos G, Bouillon R (1995) Vitamin D metabolites in childhood nephrotic syndrome. Pediatr Nephrol 9:278–281CrossRefPubMed
8.
Zurück zum Zitat Bennett MR, Pordal A, Haffner C, Pleasant L, Ma Q, Devarajan P (2016) Urinary vitamin D - binding protein as a biomarker of steroid-resistant nephrotic syndrome. Biomark Insights 11:1–6CrossRefPubMedPubMedCentral Bennett MR, Pordal A, Haffner C, Pleasant L, Ma Q, Devarajan P (2016) Urinary vitamin D - binding protein as a biomarker of steroid-resistant nephrotic syndrome. Biomark Insights 11:1–6CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Banerjee S, Basu S, Sengupta J (2013) Vitamin D in nephrotic syndrome remission: a case-control study. Pediatr Nephrol 28:1983–1989CrossRefPubMed Banerjee S, Basu S, Sengupta J (2013) Vitamin D in nephrotic syndrome remission: a case-control study. Pediatr Nephrol 28:1983–1989CrossRefPubMed
10.
Zurück zum Zitat Freundlich M, Bourgoignie JJ, Zilleruelo G, Abitbol C, Canterbury JM, Strauss J (1986) Calcium and vitamin D metabolism in children with nephrotic syndrome. J Pediatr 108:383–387CrossRefPubMed Freundlich M, Bourgoignie JJ, Zilleruelo G, Abitbol C, Canterbury JM, Strauss J (1986) Calcium and vitamin D metabolism in children with nephrotic syndrome. J Pediatr 108:383–387CrossRefPubMed
11.
Zurück zum Zitat Huang JP, Bai KM, Wang BL (1992) Vitamin D and calcium metabolism in children with nephrotic syndrome of normal renal function. Chin Med J 105:828–832PubMed Huang JP, Bai KM, Wang BL (1992) Vitamin D and calcium metabolism in children with nephrotic syndrome of normal renal function. Chin Med J 105:828–832PubMed
12.
Zurück zum Zitat Weng FL, Shults J, Herskovitz RM, Zemel BS, Leonard MB (2005) Vitamin D insufficiency in steroid-sensitive nephrotic syndrome in remission. Pediatr Nephrol 20:56–63CrossRefPubMed Weng FL, Shults J, Herskovitz RM, Zemel BS, Leonard MB (2005) Vitamin D insufficiency in steroid-sensitive nephrotic syndrome in remission. Pediatr Nephrol 20:56–63CrossRefPubMed
13.
Zurück zum Zitat Biyikli NK, Emre S, Sirin A, Bilge I (2004) Biochemical bone markers in nephrotic children. Pediatr Nephrol 19:869–873CrossRefPubMed Biyikli NK, Emre S, Sirin A, Bilge I (2004) Biochemical bone markers in nephrotic children. Pediatr Nephrol 19:869–873CrossRefPubMed
14.
Zurück zum Zitat Gulati S, Sharma RK, Gulati K, Singh U, Srivastava A (2005) Longitudinal follow-up of bone mineral density in children with nephrotic syndrome and the role of calcium and vitamin D supplements. Nephrol Dial Transplant 20:1598–1603CrossRefPubMed Gulati S, Sharma RK, Gulati K, Singh U, Srivastava A (2005) Longitudinal follow-up of bone mineral density in children with nephrotic syndrome and the role of calcium and vitamin D supplements. Nephrol Dial Transplant 20:1598–1603CrossRefPubMed
15.
Zurück zum Zitat Chen Y, Wan JX, Jiang DW, Fu BB, Cui J, Li GF, Chen CM (2015) Efficacy of calcitriol in treating glucocorticoid induced osteoporosis in patients with nephrotic syndrome: an open-label, randomized controlled study. Clin Nephrol 84:262–269CrossRefPubMed Chen Y, Wan JX, Jiang DW, Fu BB, Cui J, Li GF, Chen CM (2015) Efficacy of calcitriol in treating glucocorticoid induced osteoporosis in patients with nephrotic syndrome: an open-label, randomized controlled study. Clin Nephrol 84:262–269CrossRefPubMed
16.
Zurück zum Zitat Bucak IH, Ozturk AB, Almis H, Cevik MÖ, Tekin M, Konca Ç, Turgut M, Bulbul M (2016) Is there a relationship between low vitamin D and rotaviral diarrhea? Pediatr Int 58:270–273CrossRefPubMed Bucak IH, Ozturk AB, Almis H, Cevik MÖ, Tekin M, Konca Ç, Turgut M, Bulbul M (2016) Is there a relationship between low vitamin D and rotaviral diarrhea? Pediatr Int 58:270–273CrossRefPubMed
17.
Zurück zum Zitat Facchini L, Venturini E, Galli L, de Martino M, Chiappini E (2015) Vitamin D and tuberculosis: a review on a hot topic. J Chemother 27:128–138CrossRefPubMed Facchini L, Venturini E, Galli L, de Martino M, Chiappini E (2015) Vitamin D and tuberculosis: a review on a hot topic. J Chemother 27:128–138CrossRefPubMed
18.
Zurück zum Zitat Larkin A, Lassetter J (2014) Vitamin D deficiency and acute lower respiratory infections in children younger than 5 years: identification and treatment. J Pediatr Health Care 28:572–582; quiz 583–584CrossRefPubMed Larkin A, Lassetter J (2014) Vitamin D deficiency and acute lower respiratory infections in children younger than 5 years: identification and treatment. J Pediatr Health Care 28:572–582; quiz 583–584CrossRefPubMed
19.
Zurück zum Zitat Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M (2013) Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis 57:392–397CrossRefPubMedPubMedCentral Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M (2013) Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis 57:392–397CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Bozzetto S, Carraro S, Giordano G, Boner A, Baraldi E (2012) Asthma, allergy and respiratory infections: the vitamin D hypothesis. Allergy 67:10–17CrossRefPubMed Bozzetto S, Carraro S, Giordano G, Boner A, Baraldi E (2012) Asthma, allergy and respiratory infections: the vitamin D hypothesis. Allergy 67:10–17CrossRefPubMed
21.
Zurück zum Zitat Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G (2016) Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev 96:365–408CrossRefPubMed Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G (2016) Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev 96:365–408CrossRefPubMed
22.
Zurück zum Zitat Pereira Wde F, Brito-Melo GE, Guimarães FT, Carvalho TG, Mateo EC, Simões e Silva AC (2014) The role of the immune system in idiopathic nephrotic syndrome: a review of clinical and experimental studies. Inflamm Res 63:1–12CrossRefPubMed Pereira Wde F, Brito-Melo GE, Guimarães FT, Carvalho TG, Mateo EC, Simões e Silva AC (2014) The role of the immune system in idiopathic nephrotic syndrome: a review of clinical and experimental studies. Inflamm Res 63:1–12CrossRefPubMed
23.
Zurück zum Zitat Indian Pediatric Nephrology Group, Indian Academy of Pediatrics, Bagga A, Ali U, Banerjee S, Kanitkar M, Phadke KD, Senguttuvan P, Sethi S, Shah M (2008) Management of steroid sensitive nephrotic syndrome: revised guidelines. Indian Pediatr 45:203–214 Indian Pediatric Nephrology Group, Indian Academy of Pediatrics, Bagga A, Ali U, Banerjee S, Kanitkar M, Phadke KD, Senguttuvan P, Sethi S, Shah M (2008) Management of steroid sensitive nephrotic syndrome: revised guidelines. Indian Pediatr 45:203–214
24.
Zurück zum Zitat Choudhary S, Agarwal I, Seshadri MS (2014) Calcium and vitamin D for osteoprotection in children with new-onset nephrotic syndrome treated with steroids: a prospective, randomized, controlled, interventional study. Pediatr Nephrol 29:1025–1032CrossRefPubMed Choudhary S, Agarwal I, Seshadri MS (2014) Calcium and vitamin D for osteoprotection in children with new-onset nephrotic syndrome treated with steroids: a prospective, randomized, controlled, interventional study. Pediatr Nephrol 29:1025–1032CrossRefPubMed
25.
Zurück zum Zitat Buehring B, Viswanathan R, Binkley N, Busse W (2013) Glucocorticoid-induced osteoporosis: an update on effects and management. J Allergy Clin Immunol 132:1019–1030CrossRefPubMed Buehring B, Viswanathan R, Binkley N, Busse W (2013) Glucocorticoid-induced osteoporosis: an update on effects and management. J Allergy Clin Immunol 132:1019–1030CrossRefPubMed
26.
Zurück zum Zitat Leonard MB (2007) Glucocorticoid-induced osteoporosis in children: impact of the underlying disease. Pediatrics 119 [Suppl 2]:S166–S174CrossRefPubMed Leonard MB (2007) Glucocorticoid-induced osteoporosis in children: impact of the underlying disease. Pediatrics 119 [Suppl 2]:S166–S174CrossRefPubMed
27.
Zurück zum Zitat Mishra OP, Meena SK, Singh SK, Prasad R, Mishra RN (2009) Bone mineral density in children with steroid-sensitive nephrotic syndrome. Indian J Pediatr 76:1237–1239CrossRefPubMed Mishra OP, Meena SK, Singh SK, Prasad R, Mishra RN (2009) Bone mineral density in children with steroid-sensitive nephrotic syndrome. Indian J Pediatr 76:1237–1239CrossRefPubMed
28.
Zurück zum Zitat Esbjörner E, Arvidsson B, Jones IL, Palmér M (2001) Bone mineral content and collagen metabolites in children receiving steroid treatment for nephrotic syndrome. Acta Paediatr 90:1127–1130CrossRefPubMed Esbjörner E, Arvidsson B, Jones IL, Palmér M (2001) Bone mineral content and collagen metabolites in children receiving steroid treatment for nephrotic syndrome. Acta Paediatr 90:1127–1130CrossRefPubMed
29.
Zurück zum Zitat Moon RJ, Gilbert RD, Page A, Murphy L, Taylor P, Cooper C, Dennison EM, Davies JH (2014) Children with nephrotic syndrome have greater bone area but similar volumetric bone mineral density to healthy controls. Bone 58:108–113CrossRefPubMed Moon RJ, Gilbert RD, Page A, Murphy L, Taylor P, Cooper C, Dennison EM, Davies JH (2014) Children with nephrotic syndrome have greater bone area but similar volumetric bone mineral density to healthy controls. Bone 58:108–113CrossRefPubMed
30.
Zurück zum Zitat Leonard MB, Feldman HI, Shults J, Zemel BS, Foster BJ, Stallings VA (2004) Long-term, high-dose glucocorticoids and bone mineral content in childhood glucocorticoid-sensitive nephrotic syndrome. N Engl J Med 351:868–875CrossRefPubMed Leonard MB, Feldman HI, Shults J, Zemel BS, Foster BJ, Stallings VA (2004) Long-term, high-dose glucocorticoids and bone mineral content in childhood glucocorticoid-sensitive nephrotic syndrome. N Engl J Med 351:868–875CrossRefPubMed
31.
Zurück zum Zitat Polito C, La Manna A, Todisco N, Cimmaruta E, Sessa G, Pirozzi M (1995) Bone mineral content in nephrotic children on long-term, alternate-day prednisone therapy. Clin Pediatr (Phila) 34:234–236CrossRef Polito C, La Manna A, Todisco N, Cimmaruta E, Sessa G, Pirozzi M (1995) Bone mineral content in nephrotic children on long-term, alternate-day prednisone therapy. Clin Pediatr (Phila) 34:234–236CrossRef
32.
Zurück zum Zitat Phan V, Blydt-Hansen T, Feber J, Alos N, Arora S, Atkinson S, Bell L, Clarson C, Couch R, Cummings EA, Filler G, Grant RM, Grimmer J, Hebert D, Lentle B, Ma J, Matzinger M, Midgley J, Pinsk M, Rodd C, Shenouda N, Stein R, Stephure D, Taback S, Williams K, Rauch F, Siminoski K, Ward LM, Canadian STOPP Consortium (2014) Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome. Osteoporos Int 25:627–637CrossRefPubMed Phan V, Blydt-Hansen T, Feber J, Alos N, Arora S, Atkinson S, Bell L, Clarson C, Couch R, Cummings EA, Filler G, Grant RM, Grimmer J, Hebert D, Lentle B, Ma J, Matzinger M, Midgley J, Pinsk M, Rodd C, Shenouda N, Stein R, Stephure D, Taback S, Williams K, Rauch F, Siminoski K, Ward LM, Canadian STOPP Consortium (2014) Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome. Osteoporos Int 25:627–637CrossRefPubMed
33.
Zurück zum Zitat Hahn D, Hodson EM, Willis NS, Craig JC (2015) Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev 3:CD001533 Hahn D, Hodson EM, Willis NS, Craig JC (2015) Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev 3:CD001533
34.
Zurück zum Zitat Lombel RM, Gipson DS, Hodson EM (2013) Kidney disease: improving global outcomes. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO. Pediatr Nephrol 28:415–426CrossRefPubMed Lombel RM, Gipson DS, Hodson EM (2013) Kidney disease: improving global outcomes. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO. Pediatr Nephrol 28:415–426CrossRefPubMed
35.
Zurück zum Zitat Pańczyk-Tomaszewska M, Adamczuk D, Kisiel A, Skrzypczyk P, Przedlacki J, Górska E, Stelmaszczyk-Emmel A, Demkow U, Roszkowska-Blaim M (2015) Markers of bone metabolism in children with nephrotic syndrome treated with corticosteroids. Adv Exp Med Biol 840:21–28CrossRefPubMed Pańczyk-Tomaszewska M, Adamczuk D, Kisiel A, Skrzypczyk P, Przedlacki J, Górska E, Stelmaszczyk-Emmel A, Demkow U, Roszkowska-Blaim M (2015) Markers of bone metabolism in children with nephrotic syndrome treated with corticosteroids. Adv Exp Med Biol 840:21–28CrossRefPubMed
36.
Zurück zum Zitat Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRefPubMed Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRefPubMed
37.
Zurück zum Zitat Malihi Z, Wu Z, Stewart AW, Lawes CM, Scragg R (2016) Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis. Am J Clin Nutr 104:1039–1051CrossRefPubMed Malihi Z, Wu Z, Stewart AW, Lawes CM, Scragg R (2016) Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis. Am J Clin Nutr 104:1039–1051CrossRefPubMed
38.
Zurück zum Zitat Vogiatzi MG, Jacobson-Dickman E, MD DB, Drugs and Therapeutics Committee of The Pediatric Endocrine Society (2014) Vitamin D supplementation and risk of toxicity in pediatrics: a review of current literature. J Clin Endocrinol Metab 99:1132–1141CrossRefPubMed Vogiatzi MG, Jacobson-Dickman E, MD DB, Drugs and Therapeutics Committee of The Pediatric Endocrine Society (2014) Vitamin D supplementation and risk of toxicity in pediatrics: a review of current literature. J Clin Endocrinol Metab 99:1132–1141CrossRefPubMed
39.
Zurück zum Zitat Aggarwal A, Yadav AK, Ramachandran R, Kumar V, Kumar V, Sachdeva N, Khandelwal N, Jha V (2016) Bioavailable vitamin D levels are reduced and correlate with bone mineral density and markers of mineral metabolism in adults with nephrotic syndrome. Nephrology (Carlton) 21:483–489CrossRef Aggarwal A, Yadav AK, Ramachandran R, Kumar V, Kumar V, Sachdeva N, Khandelwal N, Jha V (2016) Bioavailable vitamin D levels are reduced and correlate with bone mineral density and markers of mineral metabolism in adults with nephrotic syndrome. Nephrology (Carlton) 21:483–489CrossRef
40.
Zurück zum Zitat Yao P, Sun L, Lu L, Ding H, Chen X, Tang L, Xu X, Liu G, Hu Y, Ma Y, Wang F, Jin Q, Zheng H, Yin H, Zeng R, Chen Y, Hu FB, Li H, Lin X (2017) Effects of genetic and non-genetic factors on Total and bioavailable 25(OH)D responses to vitamin D supplementation. J Clin Endocrinol Metab 102:100–110PubMed Yao P, Sun L, Lu L, Ding H, Chen X, Tang L, Xu X, Liu G, Hu Y, Ma Y, Wang F, Jin Q, Zheng H, Yin H, Zeng R, Chen Y, Hu FB, Li H, Lin X (2017) Effects of genetic and non-genetic factors on Total and bioavailable 25(OH)D responses to vitamin D supplementation. J Clin Endocrinol Metab 102:100–110PubMed
41.
Zurück zum Zitat Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M, Tamez H, Zhang D, Bhan I, Karumanchi SA, Powe NR, Thadhani R (2013) Vitamin D-binding protein and vitamin D status of black Americans and white Americans. N Engl J Med 69:1991–2000CrossRef Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M, Tamez H, Zhang D, Bhan I, Karumanchi SA, Powe NR, Thadhani R (2013) Vitamin D-binding protein and vitamin D status of black Americans and white Americans. N Engl J Med 69:1991–2000CrossRef
Metadaten
Titel
The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome
verfasst von
Sushmita Banerjee
Surupa Basu
Ananda Sen
Jayati Sengupta
Publikationsdatum
19.07.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 11/2017
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-017-3716-2

Neu im Fachgebiet Pädiatrie

Ab sofort gelten die neuen Verordnungsausnahmen für Lipidsenker

Freie Fahrt für Lipidsenker? Das nicht, doch mit niedrigerem Schwellenwert fürs Infarktrisiko und neuen Indikationen hat der G-BA die Verordnungs-Handbremse ein gutes Stück weit gelockert.

ADHS-Kranke verlieren sieben Lebensjahre

  • 11.02.2025
  • ADHS
  • Nachrichten

Ein ADHS verkürzt die Lebenserwartung um rund sieben Jahre, bei Frauen sind es sogar fast neun Jahre. Ein Großteil der erhöhten Sterblichkeit lässt sich auf modifizierbare Risikofaktoren wie Alkohol, Rauchen und psychische Begleiterkrankungen zurückführen.

Abdominale CT bei Kindern: 40% mit Zufallsbefunden

Wird bei Kindern mit stumpfem Trauma eine CT des Bauchraums veranlasst, sind in rund 40% der Fälle Auffälligkeiten zu sehen, die nichts mit dem Trauma zu tun haben. Die allerwenigsten davon sind klinisch relevant.

Steigende Zahl von Skorbut-Fällen bei Kindern

Eine Erkrankung, die eigentlich der Vergangenheit angehören sollte, scheint in reichen westlichen Nationen wieder häufiger aufzutreten: Seit der Coronapandemie steigt bei Kindern und Jugendlichen in Frankreich die Inzidenz von Skorbut.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.