Serum RANKL, osteoprotegerin (OPG), and RANKL/OPG ratio in nephrotic children.

Pediatr Nephrol 25(10):2067-75 (2010) PMID 20602239 PMCID PMC2923718

Receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) play key roles in the pathogenesis of glucocorticoid-induced osteoporosis (GIO). The aim of our study was to determine whether the cumulative glucocorticoid dose (CGCS) in children with idiopathic nephrotic syndrome (INS) has any effect on the concentration of serum RANKL and OPG and the RANKL/OPG ratio. The study population consisted of 90 children with INS, aged 3-20 years, who were treated with GCS. These children were divided into two groups according to the CGCS: low (L)or=1 g/kg BW, respectively. The control group (C) consisted of 70 healthy children. RANKL concentration was observed to be significantly higher and OPG significantly lower in INS children than in the reference group: 0.21 (range 0.01-1.36) versus 0.15 (0-1.42) pmol/l (p<0.05). Based on these results, we suggest that long-term exposure to GCS results in a dose-dependent increase in serum RANKL concentration and the RANKL/OPG ratio, but not in the level of serum OPG.