Efficacy Of Zinc Supplementation In Maintaining Sustained Remission In Children With Steroid-Sensitive Nephrotic Syndrome

Background: Nephrotic syndrome (NS) is one of the most prevalent primary glomerular diseases affecting children, causing significant morbidity. This study was performed to determine the efficacy of zinc supplementation in maintaining sustained remission (SR) in children with steroid sensitive nephrotic syndrome (SSNS). Methods: This randomized controlled trial was conducted at the Pediatric Medicine Outpatient Department, Nishtar Hospital, Multan, from July 2024 to May 2025. A total of 192 children aged 2–12 years with frequently relapsing were enrolled through random sampling, and randomly assigned to receive either zinc supplementation plus standard therapy or standard therapy alone for six months. Zinc was given as 5 mg (<4 years) or 10 mg (>4 years) daily, and SR was assessed. Data were analyzed using SPSS v26.0, with chi-square, and independent sample t-test applied, taking p<0.05 was considered significant. Results: In a total of 192 children, 117 (60.9%) were male. The mean age, and duration of disease was 7.36 ± 2.02 years, and 2.03±0.61 years, respectively. The mean number of relapses was 2.15±0.41. Overall, the efficacy was noted in 74 (38.5%) children. The efficacy was seen in 46 (47.9%) children in Zinc group while no Zinc group showed efficacy in 28 (29.2%) children (p = 0.011). Efficacy was found to have significant association with socio-economic status in zinc treated group (p=0.044). Conclusion; This study support the use of Zinc supplementation in pediatric SSNS, exhibiting significant efficacy in imparting remission of relapses. Keywords: Nephrotic syndrome, prednisolone, proteinuria, relapse, zinc. Trial Registration: NCT06860620 (clinicaltrials.gov)