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Springer, Pediatric Nephrology, 7(30), p. 1043-1046, 2015

DOI: 10.1007/s00467-015-3106-6

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Corticosteroids for the initial episode of steroid-sensitive nephrotic syndrome

Journal article published in 2015 by Elisabeth M. Hodson, Deirdre Hahn ORCID, Jonathan C. Craig
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

IntroductionThe International Study of Kidney Disease in Children (ISKDC) arbitrarily determined a standard-dose prednisolone regimen for the first episode of nephrotic syndrome [1]. This comprised 4 weeks of daily prednisolone (60 mg/m2/day; maximum dose 80 mg) followed by 4 weeks of prednisolone (40 mg/m2/day; maximum dose 60 mg) given on 3 consecutive days out of 7. After the Arbeitsgemeinschaft für Pädiatrische Nephrologie demonstrated in a randomized controlled trial (RCT) that alternate-day prednisolone therapy was more effective than intermittent doses of prednisolone in maintaining remission [2], alternate-day prednisolone dosing became the standard regimen for the second month of therapy. However, because of the high relapse rate with 2 months of prednisolone therapy, RCTs have investigated the benefits and harms of longer courses of therapy compared with 2 or 3 months.Combining the evidence from RCTsIn 2000 we published a systematic review of RCTs which evaluated corticostero ...