{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:37:56Z","timestamp":1777865876643,"version":"3.51.4"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Guangzhou Women and Children\u2019s Medical Center 1020 Clinical Research Project","award":["CWCMC2020-6-016"],"award-info":[{"award-number":["CWCMC2020-6-016"]}]},{"DOI":"10.13039\/501100010256","name":"Guangzhou Municipal Science and Technology Project","doi-asserted-by":"publisher","award":["201904010476"],"award-info":[{"award-number":["201904010476"]}],"id":[{"id":"10.13039\/501100010256","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study sought to explore the bone metabolism clinical features of pediatric nephrotic syndrome (NS) patients receiving glucocorticoid (GC) therapy and evaluate the bone-protective and renal-protective efficacy of alfacalcidol in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective randomized cohort study was conducted at the Department of Nephrology, Guangzhou Women and Children\u2019s Medical Center, enrolling 86 children from January 2021 to June 2022. Participants were randomized into two groups (n = 43 each): the alfacalcidol group administered 0.05\u00a0\u00b5g\/kg alfacalcidol plus 300\u00a0mg calcium daily, and the control group given 400\u00a0IU vitamin D3 plus 300\u00a0mg calcium daily. Primary outcomes included bone mineral density (BMD) and cumulative GC dose, measured at baseline, 3\u00a0months, 6\u00a0months and study endpoint. Secondary outcomes covered bone metabolism biomarkers (type I collagen C\u2013terminal telopeptide and type I procollagen N\u2013terminal propeptide), urine protein\u2013to\u2013creatinine ratio and proteinuria remission status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multivariate regression identified cumulative GC dose as a risk factor for BMD reduction, while alfacalcidol treatment correlated with BMD improvement. Lumbar spine BMD increased by 0.028\u00a0\u00b1\u00a00.008\u00a0g\/cm\u00b2 in the alfacalcidol group versus 0.002\u00a0\u00b1\u00a00.008\u00a0g\/cm\u00b2 decrease in the control group (P\u00a0=\u00a0.035). Alfacalcidol recipients had lower cumulative GC doses, shorter time to initial urinary protein negativity (7 vs 11 days, P\u00a0=\u00a0.004), higher 1\u2013year GC discontinuation rate (67.9% vs 38.7%, P\u00a0=\u00a0.025), lower proteinuria relapse rate (7.9% vs 41.9%, P\u00a0=\u00a0.045) and more favorable proteinuria remission survival curves (P\u00a0=\u00a0.035).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alfacalcidol may have potential bone-protective and renal-protective effects in pediatric NS patients undergoing GC therapy (Trial registration: ChiCTR2200055790).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag055","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:39:27Z","timestamp":1771591167000},"source":"Crossref","is-referenced-by-count":0,"title":["Alfacalcidol plus calcium versus cholecalciferol in glucocorticoid-exposed children with nephrotic syndrome: a randomized controlled trial"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0769-1463","authenticated-orcid":false,"given":"Huan Ru","family":"Chen","sequence":"first","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University Department of Pediatrics, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Tang","sequence":"additional","affiliation":[{"name":"Guangzhou Institute of Pediatrics, Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University Department of Nephrology, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Ai","family":"Lin","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University Department of Nephrology, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao Qing","family":"Lin","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University Department of Nephrology, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University Department of Nephrology, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University Department of Nephrology, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui Min","family":"Xia","sequence":"additional","affiliation":[{"name":"Guangzhou Institute of Pediatrics, Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7741-5712","authenticated-orcid":false,"given":"Xia","family":"Gao","sequence":"additional","affiliation":[{"name":"Guangzhou Women and Children\u2019s Medical Center, Guangzhou Medical University Department of Nephrology, , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4725-5433","authenticated-orcid":false,"given":"Xin","family":"Liao","sequence":"additional","affiliation":[{"name":"Guangzhou Women and 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