Lipoprotein (a) and Other Dyslipidemia in Saudi Children with Nephrotic Syndrome (SSNS and SRNS)

Hyperlipidemia is commonly associated with nephrotic syndrome (NS). We have investigated lipoprotein (a) [LP (a)] level and other lipid abnormalities in Saudi children with primary nephrotic syndrome (steroid sensitive and steroid resistant NS). Thirty eight children with primary nephrotic syndrome who were followed up at King Abdulaziz University in Jeddah were recruited for the study on second half of 2009. Their mean age ± SD =8.76± 3.8 years. They were classified into group 1; steroid sensitive nephrotic syndrome (SSNS), group 2; steroid resistant nephrotic syndrome in remission (SRNS ), group 3; SRNS not in remission , and compared them with 27 controls of normal children. Serum creatinine, serum albumin and fasting serum lipids were measured in all patients. In addition urine protein was measured on the same day of blood samples. There was a significant increase in cholesterol, triglyceride and low density lipoprotein (LDL) concentrations in SRNS as compared to controls, SSNS and SRNS . All groups showed a significant increase in high density lipoprotein (HDL) levels. There was a significant increase in LP (a) level (P < 0.001) in SRNS group and in SSNS group (P< 0.05) compared to control group. However, a non significant increase (p=0.06) was observed in SRNS group. No significant changes were observed in apoprotein A1 (Apo AI) and Apo B levels between group 1, group 2, group 3 and the control group. In the SRNS group; there was positive correlation between cholesterol and triglyceride, cholesterol and LDL and triglyceride and Apo B. There was negative correlation between cholesterol and albumin, triglyceride and albumin and LDL and albumin. In conclusion, SRNS in children was associated with high LP (a) and dyslipidemia which was not completely normalized in children who achieved remission.