Related Experiment Videos

A randomized study of two long-course prednisolone regimens for nephrotic syndrome in children

Masahiro Hiraoka1, Hirokazu Tsukahara, Kousaku Matsubara

  • 1Department of Pediatrics, Fukui Medical University School of Medicine, Fukui, Japan. hiraoka@fmsrsa.fukui-med.ac.jp

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 31, 2003
PubMed

Insights

The long alternate-day prednisolone regimen is more effective for sustaining remission in childhood nephrotic syndrome, especially in younger children. This approach also shows fewer corticosteroid toxicities compared to the long daily regimen.

Area of Science:

  • Pediatric Nephrology
  • Pharmacology
  • Clinical Trial Design

Background:

  • Long-course prednisolone is effective for nephrotic syndrome remission in children.
  • Optimal long-course regimen for sustained remission remains unclear.

Purpose of the Study:

  • Compare the efficacy and safety of two long-course prednisolone regimens.
  • Identify the most beneficial regimen for sustained remission in childhood nephrotic syndrome.

Main Methods:

  • 73 children with new-onset nephrotic syndrome were randomized to two groups.
  • Group A: long daily regimen (6 weeks daily, 6 weeks alternate-day).
  • Group B: long alternate-day regimen (4 weeks daily, 4 weeks alternate-day, then tapered).

Main Results:

  • Group B had lower corticosteroid toxicity during initial treatment.
  • Group B showed a trend towards higher sustained remission rates (P=0.069).
  • Younger children (<4 years) in Group B had significantly better sustained remission and fewer relapses.

Conclusions:

  • The long alternate-day regimen appears more beneficial with reduced toxicity.
  • Younger children (<4 years) especially benefit from the long alternate-day regimen for sustained remission.
  • Age at onset is a key factor in treatment response for nephrotic syndrome.
Abstract

Related Concept Videos

Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document any history...
Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...