Prednisone for Steroid-Sensitive Nephrotic Syndrome: Can We Use Lower Doses for the First Presentation in Children?

Elisabeth Hodson, Deirdre Hahn, Jonathan C. Craig

Research output: Contribution to journalEditorial

1 Citation (Scopus)

Abstract

Since the 1970s, the accepted standard of care for children presenting with their first episode of nephrotic syndrome has been a course of oral prednisone comprising 60 mg/m2 (2 mg/kg) daily for 4 weeks followed by 40 mg/m2 (1.5 mg/kg) on alternate days for 4 weeks with or without a tapering dose. A meta-analysis of randomized controlled trials (RCTs) in 2007 concluded that prednisone treatment for ≥3 months compared with 2 months reduced the risk of relapse at 12-24 months. However some included studies were at high risk of bias, which, on average, leads to an overestimation of the treatment effect observed. Subsequently 4 RCTs (3 of which were placebo-controlled) published between 2013 and 2019 that were at low risk of bias and involving 775 children demonstrated no benefit of extended-duration treatment beyond 8-12 weeks (with daily administration followed by alternate-day prednisone) for the outcome of first relapse or frequent relapses...
Original languageEnglish
Pages (from-to)433-435
Number of pages3
JournalAmerican Journal of Kidney Diseases
Volume80
Issue number4
Early online date1 Aug 2022
DOIs
Publication statusPublished - Oct 2022

Keywords

  • Prednisone
  • Nephrotic Syndrome
  • Child health

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