Nutritional status and laboratory characteristics of nephrotic syndrome in children undergoing steroid and non-steroid therapy at Dr. Zainoel Abidin Hospital, Banda Aceh

Syafruddin Haris* -  Department of Child Health, Faculty of Medicine, Universitas Syiah Kuala, and Department of Child Health, Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
Fahrul Riza -  Department of Child Health, Faculty of Medicine, Universitas Syiah Kuala, and Department of Child Health, Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
T. M. Thaib -  Department of Child Health, Faculty of Medicine, Universitas Syiah Kuala, and Department of Child Health, Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
Anidar Anidar -  Department of Child Health, Faculty of Medicine, Universitas Syiah Kuala, and Department of Child Health, Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
Bakhtiar Thaib -  Department of Child Health, Faculty of Medicine, Universitas Syiah Kuala, and Department of Child Health, Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
Nora Sovira -  Department of Child Health, Faculty of Medicine, Universitas Syiah Kuala, and Department of Child Health, Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
Nephrotic syndrome (NS) is a clinical condition characterized by massive proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. Frequently relapsing NS, steroid-dependent NS, and steroid-resistant NS are categorized as problematic owing to treatment difficulties. These patients require prolonged high-dose steroid therapy or immunosuppressants, resulting in significant side effects. This study evaluated the nutritional status and laboratory characteristics of NS in children undergoing steroid and non-steroid therapies. This study is the first to assess the nutritional status and laboratory characteristics of children with difficult-to-treat NS who received steroid and non-steroid therapy at RSUDZA Banda Aceh. A cross-sectional study was conducted at the outpatient clinic and pediatric ward of Dr. Zainoel Abidin General Hospital, Banda Aceh, in 2019, which was a limitation because it was conducted during the Covid-19 pandemic so that the number of research subjects was limited, which could have caused bias in the study. Statistical analyses included the chi-square test or Fisher’s exact test for categorical variables and the independent sample t-test or Mann-Whitney test for numerical variables, with a 95% significance level (p < 0,05). A total of 60 children aged 2–18 years participated in this study, with 29 receiving steroid therapy and 31 receiving non-steroid therapy. Urine protein levels and relapse incidence differed significantly between the groups (p < 0,001). However, the serum albumin, urea, creatinine, calcium, and total cholesterol levels were not significantly different. No significant differences were observed in the laboratory characteristics between the steroid and non-steroid therapy groups. However, the non-steroid group exhibited a better urine protein status and fewer relapses, indicating potential therapeutic advantages.

Keywords : Nephrotic syndrome, difficult-to-treat nephrotic syndrome, laboratory characteristics, steroids, non-steroids, immunosuppressant therapy

  1. Adrian Umboh. (2013). Hubungan Aspek Klinis dan Laboratorium pada Sindrom Nefrotik Sensitif Steroid dan Sindrom Nefrotik Resisten Steroid. Sari Pediatri, 15(No.3), 133–136.
  2. Bhimma, R. (2014). Steroid-sensitive nephrotic syndrome in children. Journal of Nephrology & Therapeutics, 11(1), 1–5.
  3. Boyer, O., Trautmann, A., Haffner, D. & Vivarelli, M. (2023). Steroid-sensitive nephrotic syndrome in children. Nephrology Dialysis Transplantation, 38(5), 1123–1126. https://doi.org/10.1093/ndt/gfac314
  4. D Kandou Manado Valentine Umboh, P. R., Tandiawan, L., Umboh Bagian Ilmu Kesehatan Anak Fakultas Kedokteran, A., Sam Ratulangi, U. & Sakit D Kandou Manado, R. R. (2019). Luaran Pada Anak-Anak Dengan Sindroma Nefrotik Sensitif Steroid Di RSUP (Vol. 3, Issue 2).
  5. Downie, M. L., Gallibois, C., Parekh, R. S. & Noone, D. G. (2017). Nephrotic syndrome in infants and children: Pathophysiology and management. Paediatrics and International Child Health, 37(4), 248–258. https://doi.org/10.1080/20469047.2017.1374003
  6. Garniasih, D., Djais, J. T., & Garna, H. (2016). Hubungan antara kadar albumin dan kalsium serum pada sindrom nefrotik anak. Sari Pediatri, 10, 100–105.
  7. Husein Albar, dan F. B. (2019). Profile of Pediatric Nephrotic Syndrome in Wahidin Sudirohusodo Hospital, Makassar, Indonesia. Cermin Dunia Kedokteran, 46(No.3), 185–188.
  8. Juliantika, R., Indah Lestari, H., Riani Kadir, M., Studi Pendidikan Dokter, P., Kedokteran, F., Sriwijaya, U., Selatan, S., Ilmu Kesehatan Anak, B., Fisiologi, B. & Jl Mohammad Ali Komplek RSMH Palembang Km, I. (2017). Korelasi antara Hipoalbuminemia dan Hiperkolesterolemia pada Anak dengan Sindrom Nefrotik.
  9. Li, S., He, C., Sun, Y., Chen, J., Liu, Y., Huang, Z., Huang, W., Meng, Y., Liu, W., Lei, X., Zhao, R., Lin, Z., Huang, C., Lei, F. & Qin, Y. (2024). Clinical characteristics and prognosis of steroid-resistant nephrotic syndrome in children: a multi-center retrospective study. Italian Journal of Pediatrics, 50 (1). https://doi.org/10.1186/s13052-024-01817-4
  10. McCaffrey, J., Lennon, R. & Webb, N. J. A. (2016). The non-immunosuppressive management of childhood nephrotic syndrome. In Pediatric Nephrology (Vol. 31, Issue 9, pp. 1383–1402). Springer Verlag. https://doi.org/10.1007/s00467-015-3241-0
  11. Primashanti Dewi, D. A. D. (2019). Risk factors for steroid-resistant nephrotic syndrome in children. Medicina (Buenos Aires), 50(2), 67–71.
  12. Pardede, S. O. & Rahmartani, L. D. (2016). April-Juni Tinjauan Pustaka Tata Laksana Sindrom Nefrotik Resisten Steroid pada Anak. In Majalah Kedokteran UKI (Issue 2).
  13. GAP Nilawati. (2012). Profil sindrom nefrotik pada ruang perawatan anak (Vol. 14, Issue 4).
  14. Trautmann, A., Boyer, O., Hodson, E., Bagga, A., Gipson, D. S., Samuel, S., Wetzels, J., Alhasan, K., Banerjee, S., Bhimma, R., Bonilla-Felix, M., Cano, F., Christian, M., Hahn, D., Kang, H. G., Nakanishi, K., Safouh, H., Trachtman, H., Xu, H., … McCulloch, M. (2023). IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome. Pediatric Nephrology, 38(3), 877–919. https://doi.org/10.1007/s00467-022-05739-3
  15. Trihono, P. P., Fahlevi, R., Kinesya, E., Hidayati, E. L., Puspitasari, H. A. & Pardede, S. O. (2023). Sindrom Nefrotik Idiopatik Sensitif Steroid pada Anak: Telaah Perbandingan Panduan Klinis (Vol. 25, Issue 4).
  16. Uwaezuoke, S. N. (2015). Steroid-sensitive nephrotic syndrome in children: Triggers of relapse and evolving hypotheses on pathogenesis. In Italian Journal of Pediatrics (Vol. 41, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13052-015-0123-9
  17. Valavi, E., Nickavar, A., Amoori, P., Fathi, M. & Valavi, B. (2023). Predictive risk factors of steroid dependent nephrotic syndrome in children with idiopathic nephrotic syndrome. Journal of Nephropharmacology, 12 (2). https://doi.org/10.34172/npj.2023.10571

Open Access Copyright (c) 2025 Syafruddin Haris, Fahrul Riza, T. M. Thaib, Anidar Anidar, Bakhtiar Thaib, Nora Sovira
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
Website: https://gizipoltekkesaceh.ac.id/
E-mail: jurnal6121@gmail.com

e-issn: 2548-5741, p-issn: 2527-3310

All content is licensed under a: Creative Commons Attribution ShareAlike 4.0 International License

View My Stats

Get a feed by atom here, RRS2 here and OAI Links here