Abstract Ref Number = APCP280
THE EFFECT OF 25(OH)D3 SUPPLEMENTATION ON GLUCOCORTICOID RECEPTOR BETA LEVEL AND 25(OH)D PLASMA LEVEL IN PEDIATRIC NEPHROTIC SYNDROME
Wenny Prafitriyanti,Harinda Khanifa,Dian Maharani,Astrid Kristina Kardani,Krisni Subandiyah
Paediatric Department Medical Faculty of Brawijaya University Saiful Anwar General Hospital Malang East Java Indonesia Nephrology Division Paediatric Department, Medical Faculty of Brawijaya University, Saiful Anwar General Hospital Malang, East Java, Indonesia
Background : Pediatric nephrotic syndrome is the most common presentation glomerular disease which characterized by several clinical manifestations such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. In Indonesia, the incidence of this disease was 6 cases per 100.000 children per year in children aged less than 14 years old and dominated by male (male: female ratio 2:1). Glucocorticoid/corticosteroid is the main treatment for nephrotic syndrome. Glucocorticoid is an anti-inflamation, which bind to glucocorticoid reseptor alpha (GRalpha). It is reported that glucocorticoid receptor beta (GRbeta) is a main inhibitor of GRalpha. The interaction between glucocorticoid receptors and 25(OH)D3 can increase anti-inflammation at glucocorticoid receptors and decrease GRbeta levels. The aim of this study is to investigate the effect of 25(OH)D3 on glucocorticoid receptor beta level and 25(OH)D plasma level in children with pediatric nephrotic syndrome and the correlation between both of the parameters.
Material : This study was designed as a randomized clinical trial, double blind, pre and post-test control group which involved 30 subjects that newly diagnosed as pediatric nephrotic syndrome. Subjects were divided into 2 groups, prednisone and 25(OH)D3 treated group (G1) and prednisone only treated group (G2). GRbeta level (Mybiosource Cat#MBS039666) and 25(OH)D plasma level was measured by ELISA method. Data was analyzed by kolmogorov-smirnov, independent t test, and Pearson correlation with significant value p<0.05.
Results : Results showed that there was significant elevation of 25(OH)D plasma (independent t-test, p=0.001) between G1 and G2, and significant decrease of GRbeta levels (p=0,029) in prednisone and 25(OH)D3 treated group as compared to prednisone only treated group. Pearson testing first group showed that 25(OH)D3 level was positively correlated with GRbeta levels (r -0,458; p= 0,01).
Conclusions : The effect of 25(OH)D3 supplementation can increase 25(OH)D plasma level and decrease of GRbeta levels significantly in children with pediatric nephrotic syndrome who receive glucocorticoid therapy.
Keywords: 25(OH)D3 Glucocorticoid receptor beta Pediatric Nephrotic Syndrome Pediatric