Retinol-binding protein 4 (RBP4) and prealbumin (PA) serum concentration and bioimpedance parameters as selected markers of nutritional status in children with nephrotic syndrome.

BACKGROUND

Nephrotic syndrome (NS) is a clinical condition that results from the renal loss of protein exceeding the body's compensatory abilities. Dysproteinemia in the acute phase of the disease inevitably affects the nutritional status of children. It is unclear whether the situation will fully normalize in remission. The aim of the study was to assess the serum concentrations of retinol binding protein 4 (RBP4) and prealbumin (PA), as well as the body composition parameters in children with NS in remission in comparison to healthy counterparts.

METHODS

Thirty nephrotic children at the age of 11.9 ± 4.6 years were enrolled and compared to healthy counterparts. RBP4 and PA serum concentrations together with selected basic biochemical parameters, were determined. Body composition parameters were determined based on the bioimpedance method using the Tanita MC-980MA device.

RESULTS

In NS children the mean RBP4 concentration was 42.6 ± 11.6 mg/l, and mean PA concentration was 540.1 ± 442.1 µg/ml, and those values did not differ significantly from those in the control group (42.0 ± 10.9 mg/l and 372.8 ± 107.9 µg/ml, respectively). RBP4 concentration correlated positively with the age of the studied patients, while PA was not associated with age. Both studied markers did not show significant differences depending on the remission status - maintained with immunosuppressive therapy vs. without active treatment, as well as on the categorization according to the clinical course - steroid-sensitive NS vs. frequently relapsing or steroid-dependent NS. Based on bioimpedance measurements, the parameters characterizing body composition did not differ between NS group and controls.

CONCLUSIONS

RBP4 and PA, which can be considered as selected biochemical markers of nutritional status, as well as body composition measures based on the bioimpedance, do not indicate differences between children with remission of idiopathic NS and their healthy peers. Successful induction and maintenance of NS remission restores the assessed aspects of nutritional status of these children.