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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Patients with primary nephrotic syndromes (PNS) are treated with long courses of corticosteroids. Steroids are known to cause deleterious side effects including steroid induced hyperglycemia (SIH). However, there is a paucity of literature regarding SIH in patients with PNS. Steroids typically cause a prandial hyperglycemia - in non-diabetic patients, SIH may be underdiagnosed using serum fasting glucose and HbA1c. The above reasons may lead to an under-recognition of SIH and associated complications in this patient group.
Objectives
1. To elucidate the incidence, risk factors and complications of SIH in non-diabetic patients with PNS treated with corticosteroids.
2. To ascertain which glycemic index (serum fasting glucose, Hba1c, serum random glucose) is most sensitive for diagnosing SIH in non-diabetic patients.
A single centre retrospective analysis was performed on PNS patients with a renal biopsy done between 2014-2016 and 2022-2024. Clinical, laboratory, pharmacological data were collected from corticosteroid initiation to 1-year post treatment. Primary outcome evaluated was incidence of SIH. Secondary outcomes included risk factors, screening tests and complications of SIH.
38 patients were included. The mean age was 49.8 years old, 48% female, 52% male. 26 (68%) had MCD, 12 (32%) had FSGS. Mean baseline Hba1c prior to steroids was 5.6%. 30 patients (78%) attained remission with 1st course of steroids. The mean high dose (>1mg/kg) steroid exposure was 7.7 weeks, cumulative steroid exposure was 29.9 weeks.
SIH occurred in 7 (17%) of patients. Pre-existing hypertension (71% in SIH group vs 24% in non-SIH group, p-value 0.03) and hyperlipidemia (57% in SIH group vs 21% in non-SIH group, p-value 0.02) were significantly associated with development of SIH. Patients with SIH tended to be older (mean 66 years old vs 47 years old, p-value 0.07), have a higher starting proteinuria (13.9g/day vs 10.9g/day, p-value 0.09) and were exposed to a longer duration of high dose (>1mg/kg) corticosteroids (9.3 weeks vs 7.8 weeks, p-value 0.12). Gender, baseline eGFR, baseline BMI, starting lipids, baseline serum albumin were not associated with development of SIH.
SIH occurred within 2 months of starting high dose corticosteroids and all resolved once tapered off corticosteroids. For patients who developed SIH, they had a mean fasting glucose of 5.7mmol/L, random glucose of 13.75mmol/L, Hba1c of 7%. SIH would have been missed for 4 patients if serum random glucose was not checked. Within the SIH group, 2 were admitted for diabetic ketoacidosis and a severe diabetic-related foot infection respectively. These 2 patients had a normal fasting glucose and Hba1c, with SIH only picked up via serum random glucose on admission.
Other complications of steroids included weight gain (7), infections (3), steroid induced hypertension (2), steroid induced osteoporosis (2), infections (3), Cushing’s facies (2), steroid induced psychosis (1).
Our study demonstrates the significant burden and complications of SIH in PNS patients on corticosteroids. Potential risk factors identified: pre-existing hypertension, hyperlipidemia, age, baseline proteinuria and duration of high dose steroids. Identifying patients with risk factors and using prandial glucose as a screening tool can enable earlier detection and treatment of SIH.
This abstract was submitted prior for the 15th Singapore Society of Nephrology Annual Scientific Meeting 2025.
