Effect of Prednisone on Growth and Bone Mineral Content in Childhood Glomerular Disease

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Abstract
• Children with acquired glomerular disease were divided into two groups: Group 1 patients received short-term daily or long-term alternate-day prednisone (up to 2.7 mg/kg/48 hr); group 2 patients received no corticosteroids. Height, bone mineral content (BMC), and bone density were evaluated in the two groups and compared to those of 800 sex- and age-matched controls; BMC and bone density were assessed by the photon absorption technique. Significant demineralization was present in 18 of 25 prednisone-treated and none of the 17 nonprednisone-treated patients (P <.001). Group 1 patients were 5.3 ± 0.7% shorter than controls, while group 2 patients were only 1.9 ±.8% shorter (P <.02). Height velocity was 2.6 ± 0.8 cm/yr in group 1 and 5.1 ± 0.8 cm/yr in group 2 patients (P <.05). When prednisone therapy was discontinued, six patients had an increase in height and BMC toward normal values. This study suggests that BMC and height velocity are correlated. Both appear to be influenced by alternate-day prednisone therapy rather than by glomerular disease per se. (Am J Dis Child 132:768-772, 1978)