ABSTRACT
To determine whether Zinc supplementation could reduce relapse rate in children with nephrotic syndrome. Randomized-controlled trial. National Institute of Child-Health and The Kidney Centre, Karachi, from January 2008 to June 2009. Sixty nephrotic children aged 2 - 15 years were selected. Baseline data including age, number of infections and relapses during pre and post study one year were recorded. Randomization was done to divide into Zinc group [Zg] to receive Zinc versus placebo [Pg] for 6 months. Relapses and infections were treated with standard therapy. T-test and chi-square tests were used to compare the mean values and proportions respectively with significance at p < 0.05. Among 60 children, 54 completed trial [Zg = 25, Pg = 29]. Forty [74%] were males and 14 [26%] females. Mean age, pre study relapses and Zinc level in the two groups were similar. Overall, infections and relapses were observed in 43 [79.62%] and 17 cases [31.48%] respectively. There was no significant difference in frequency of infections and mean infection rate in Zg [20, 80% and 1.92 +/- 1.47] compared to Pg [23, 79.3% and 2 +/- 1.53, p = 0.950]. Relapses occurred in 7 [28%] in Zg compared to 10 [34%] in Pg which was not significant [p = 0.609]. Mean infection and relapse rate per patient per year [PPPY] in Zg was 1.92 +/- 1.47and 1.14 +/- 0.37 compared to 2 +/- 1.53 and1.3 +/- 0.48 in Pg respectively [p=0.846, 0.464]. Pre study relapses in two groups were similar [Zg vs. Pg = 96 vs. 96.6%] whereas post study relapses in Zg were lower [7, 28%] compared to Pg [10, 34.5%]. Post study mean relapse rate in Zg was 1.14 +/- 0.37 PPPY compared to 2.71 +/- 1.11 in pre study [p = 0.005]. In Pg, post study mean relapse rate PPPY was 1.30 +/- 0.48 compared to 1.70 +/- 0.48 in pre study period [p = 0.037]. Relapse rate reduction was 43% after Zinc supplementation compared to 27% reduction in placebo. Metallic taste was observed in 10% of cases. Zinc supplementation was helpful in reducing relapses in nephrotic syndrome