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Increased maintenance corticosteroids during upper respiratory infection decrease the risk of relapse in nephrotic

T K Mattoo1, M A Mahmoud

  • 1Maternity and Children's Hospital, and King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia. tmattoo@med.wayne.edu

Nephron
|August 15, 2000
PubMed
Summary

To reduce relapses in children with idiopathic nephrotic syndrome, increasing daily prednisone during upper respiratory tract infections (URIs) significantly lowered relapse frequency in a prospective study.

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Area of Science:

  • Pediatrics
  • Nephrology
  • Immunology

Background:

  • Idiopathic nephrotic syndrome (INS) frequently relapses in children.
  • Steroid-dependent, relapsing INS requires ongoing management to minimize morbidity.

Purpose of the Study:

  • To investigate if a temporary increase in prednisone dosage during upper respiratory tract infections (URIs) can reduce relapse frequency in children with steroid-dependent nephrotic syndrome.

Main Methods:

  • A prospective study involving 36 children with steroid-dependent, relapsing INS on alternate-day prednisone maintenance therapy.
  • Patients were divided into two groups: Group 1 received daily prednisone for 5 days during URIs, while Group 2 maintained alternate-day prednisone.
  • Outcomes were assessed over a 2-year follow-up period.

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Main Results:

  • Group 1 experienced significantly fewer relapses (mean 2.2 per patient) compared to Group 2 (mean 5.5 per patient) (p = 0.04).
  • The intervention of increased prednisone during URIs demonstrated a statistically significant reduction in relapse rates.

Conclusions:

  • Temporarily increasing prednisone dosage during URIs is an effective strategy to decrease relapse frequency in children with steroid-dependent nephrotic syndrome on alternate-day therapy.
  • This approach offers a potential method to improve long-term outcomes and reduce the burden of frequent relapses in pediatric nephrotic syndrome.