Hiraoka M, Sudo M
Low versus standard dosage of prednisolone for initial
treatment of idiopathic nephrotic syndrome in children
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1335 1996
The adverse side effects of steroids in children continue to be an area
of great concern for those of us who treat this population. Investigators
in this randomized multicenter trial from the West Japan Cooperative
Study of Kidney Disease in Children prospectively compared a standard
6 week dose of oral prednisolone 60 mg/m2 to a "low" dose of 40mg/m2
in 55 children with idiopathic nephrotic syndrome (it can be safely
assumed most of these cases were minimal change disease).
Between the 27 patients on low dose and 28 patients on standard dose
treatment
there was no clinically significant difference in the occurrence of steroid
resistance, partial response, or relapse 3 months after therapy. Two
patients on standard dose therapy had to discontinue therapy because of
hypertension or an elevated LDH. There was no
difference in the incidence of adverse effects of steroids between the
groups but there was a delay in time to respond in the low dose patients.
Comment: No benefit is apparent to lowering our usual steroid dose
in treating idiopathic nephrotic syndrome in children.
(Sri Narsipur, MD, SUNY-HSC at Syracuse, NY)
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Am Soc Nephrol
Proteinuria/Hematuria :
Nephrotic syndrome in children