Nutritional Assessment of Children with Nephrotic Syndrome Attending a Tertiary Health Facility : A Case Control Study

Introduction: There is increased risk of protein energy malnutrition in children with nephrotic syndrome. Children with nephrotic syndrome are prone to both macro and micronutrient deficiency and are at risk of poor growth, muscle mass depletion and cognitive impairment. There are few works on assessing the nutritional status of children with nephrotic syndrome in Nigeria and sub-Saharan Africa. Objectives: To assess the nutritional status of children with nephrotic syndrome attending the Nephrology Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos. Method: A prospective, case-control study carried out between October 2017 and April 2018. Children with diagnosis of nephrotic syndrome were enrolled. The controls were apparently healthy children who presented to the outpatient general paediatric clinic for minor illnesses. Anthropometric parameters such as weight, height, waist to hip circumference were taken and weight to height, body mass index, weight to age, height to age were calculated. Sociodemographic information such as age, sex, religion of parents, social class were documented. Serum albumin levels were taken as well. Result: A total of 61 subjects with nephrotic syndrome were recruited. 41(67.2%) of studied subjects were males and 20(32.8%) were females with male to female ratio of 2:1. The median age of studied subjects was 72 months (80.7±42.2 months, mean ± SD). For the controls, a total of 27 children were recruited. 20 (74.1%) were males with a male to female ratio of 1.3:1 and the mean age was 80±46.4 months. The mean weight of the studied subjects was 25.13±10.45kg with a median of 23kg and in the controls, mean weight of all was 26.06±11.25kg. The mean height of subjects with nephrotic syndrome was 119.1±22.1cm and in control group 123±25.1cm. The mean body mass index in all subjects was 17.1±2.6kg/ m while in control group 16.4±2.23kg/m. Weight for age(WFA) Z score assessment was done in studied subjects not more than 10 years (120 months). 2 (4.08%) had low weight for age, in 42 (85.7%) the WFA was normal and 5(10.2%) were overweight. Compared to the controls with maximum age of 120 months (21 subjects), all except one overweight subject had normal weight for age z-score. Height for age in 7 subjects (11.5%) was <-2 to -3 which depicts stunting. 2 subjects (3.27%) were very stunted with height for age values of <-3. The remaining subjects (85.2%) had normal height for age. All control cases had normal height for age. There was a positive relationship between the use of steroid and stunting (p= 0.004). Waist to Hip ratio values between the two groups (Cases and controls) showed that the cases were more likely to have a high value compared with the controls (p=0.001). Conclusion: Children with nephrotic syndrome are indeed prone to growth impairment with associated risk of cardiovascular morbidities. Careful attention to use of simple measurements can promptly identify Nutritional Assessment of Children with Nephrotic Syndrome Attending a Tertiary Health Facility: A Case Control Study Solarin AU, Adekunle MO, Olutekunbi OA, Lamina OM, Aremu OE, Animasahun AB and Njokanma FO Lagos State University Teaching Hospital, Ikeja, Lagos 97 Corresponding author: Solarin AU, Lagos State University Teaching Hospital, Ikeja, Lagos E-mail:asolar234@gmail.com Tropical Journal of Nephrology Vol.13 No 2, December, 2018 97-103