IS THERE A NEPHROPATHY RISK FOR CHILDREN WITH ASTHMA WHO USE INHALED STEROIDS?
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Background and aim: Asthma is one of the most common chronic inflammatory diseases in children, but whether these patients, who require long-term follow-up and medication, carry a risk for nephropathy is still unknown. The purpose of this study was to investigate whether the urinary microalbumin level and urinary microalbumin/creatinine ratio, early indicators of nephropathy increase in children with asthma. Material and methods: Asthmatic children aged 10 years or older who had been on medication for at least 4.2 +/- 2.7 years were selected for this study. All patient medical histories, physical examination results, and serum amyloid A (SAA), urinary microalbumin, and urinary creatinine measurements were evaluated. Results: Twenty-one children with asthma (13 boys, eight girls) were evaluated, including 12 medication-controlled cases (57.1%) and nine cases admitted during an acute attack (42.8%). SAA levels in the acute attack cases (0.16 +/- 0.06 vs. 3.5 +/- 7.8 p < 0.001) were significantly higher than those in medically controlled cases. Urinary microalbumin was not significantly different between groups, although it was higher during acute attacks (15 +/- 19 vs. 22.6 +/- 35.2 mg/l). Ten of the patients with asthma (47.6%) had been on medication for <5 years, and 11 (52.3%) for >= 5 years. The urinary microalbumin levels (8.2 +/- 4.8 vs. 27.5 +/- 34.6 mg/l, p = 0.02) and urinary microalbumin/creatinine ratios (0.06 +/- 0.02 vs. 0.14 +/- 0.11, p = 0.016) were significantly higher in those receiving medication for >= 5 years compared with those receiving medication for <5 years. Conclusions: SAA levels increased in patients suffering from acute asthma attack. The urinary microalbumin levels and urinary microalbumin/creatinine ratios of children with asthma who had received a long-term inhaled steroid were significantly higher than those of children who had not.