A Clinical Study Of Osfieonecrosis Of The Femoral Head In Patients With Idiopathic Nephrotic Syndrome

Objective:To investigate the clinical features of osteonecrosis of the femoral head (ONFH) in patients with idiopathic nephrotic syndrome.Methods:A retrospective analysis of outpatients from January 2009 to December 2013 with ONFH the clinical data of follow-up.Results:The incidence of ONFH in 3796 idiopathic nephrotic syndrome patients which include FSGS, IgM nephropathy and minimal change nephropathy was 2.4%. 80.4% of the ONFH group was diagnosed within the first 3 years of corticosteroid therapy. Multiple factor logistic regression analysis revealed that hypoproteinemia was the risk factor of ONFH (P<0.05).There was no significant difference between two groups in glucocorticoid therapy response,the recurrence frequency of nephropathy and accumulative dosage of glucocorticoid (P>0.05).Preventive use of vitamin D and calcium can not reduce the occurrence of ONFH. There was no difference in sex, age,24-hour urine albumin excretion, hemoglobin, blood platelet,uric acid,triglyceride,total cholesterol, LDL-C,the ratio LDL-C to HDL-C, blood phosphorus between the two groups(P>0.05).Conclusions:The incidence of ONFH in patient with idiopathic nephrotic syndrome was 2.4%.The ONFH has the highest occurrence within 3 years of Glucocorticoid therapy. Hypoproteinemia is the risk factor with ONFH.Preventive use of vitamin D and calcium can not reduce the occurrence of ONFH.They should do MRI test of the hip joint routinely when the time of glucocorticoid treatment for 5 months.