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Behavioural abnormalities in children with new-onset nephrotic syndrome receiving corticosteroid therapy: results of a prospective longitudinal study

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Abstract

Background

Corticosteroid therapy can cause behavioural abnormalities in children with nephrotic syndrome. The objective of this study was to explore the timing of the appearance of abnormalities in their first episode.

Methods

Forty-five children with a first episode of idiopathic nephrotic syndrome (30 aged 2–5 and 15 aged 6–14 years) were assessed for behavioural problems using the Child Behaviour Checklist (CBCL) before, and after 6 and 12 weeks of oral steroid treatment. Sixty healthy children were included as controls.

Results

In both age groups, marked abnormalities of externalising behaviour were noticed, specifically in the domains of aggressive behaviour and attention problems. Clinical range or borderline externalising abnormalities were present in 73 % of the younger children and 60 % of the schoolchildren after 6 weeks of treatment. In the schoolchildren, abnormal internalising behaviour was also noted at 6 weeks, in 40 % at borderline level and in 20 % within the clinical range. Elevated scores were observed for the anxious/depressed and withdrawn/depressed domains. Most changes persisted at the 12-week observation.

Conclusions

Children of both age groups showed significant attention problems and aggressive and abnormal externalising behaviour within 6 weeks of starting treatment. Parents should be informed and counselled about this potential adverse effect of steroid therapy.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical disclosure

The protocol of the study was approved by Institute Ethics Committee and informed consent was taken from the parents or authorised representative of each child.

Author contributions

AU, OPM and SKU helped with the design, conduct and analysis of the study and drafted the manuscript, RP helped with the data analysis and writing of the manuscript and FS helped with the conceptualisation of study, data analysis and critical revision of the manuscript.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India

    Aishvarya Upadhyay, Om P. Mishra, Rajniti Prasad & Shashi K. Upadhyay

  2. Division of Pediatric Nephrology, Centre for Pediatrics and Adolescent Medicine, Heidelberg University Medical Centre, Heidelberg, Germany

    Franz Schaefer

Authors
  1. Aishvarya Upadhyay
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  2. Om P. Mishra
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  3. Rajniti Prasad
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  4. Shashi K. Upadhyay
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  5. Franz Schaefer
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Corresponding author

Correspondence to Om P. Mishra.

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Upadhyay, A., Mishra, O.P., Prasad, R. et al. Behavioural abnormalities in children with new-onset nephrotic syndrome receiving corticosteroid therapy: results of a prospective longitudinal study. Pediatr Nephrol 31, 233–238 (2016). https://doi.org/10.1007/s00467-015-3216-1

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  • DOI: https://doi.org/10.1007/s00467-015-3216-1

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