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[Treatment outcome using prednisone in corticosteroid-responsive primary nephrotic syndrome in children]
O Brumariu1, Florentina Cucer, Mihaela Munteanu
1niversitatea de Medicină Si Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica a IV-a Pediatrie.
Insights
A 4-month prednisone regimen effectively treats childhood nephrotic syndrome, inducing remission in most patients. This approach shows a 32.55% relapse rate with significantly fewer serious adverse effects compared to other corticoid treatments.
Area of Science:
- Pediatric Nephrology
- Pharmacology
- Clinical Medicine
Context:
- Childhood nephrotic syndrome is typically responsive to corticosteroids, with frequent relapses often linked to infections.
- Existing treatment protocols involve varying durations and dosages of corticosteroids, leading to a spectrum of efficacy and side effects.
Purpose:
- To evaluate the efficacy and safety of a 4-month prednisone regimen in pediatric patients with nephrotic syndrome.
- To analyze treatment response, relapse rates, and adverse effects associated with this specific prednisone regimen.
Summary:
- This retrospective study analyzed 83 children with nephrotic syndrome over 10 years, focusing on a 4-month prednisone course.
- Complete remission was achieved in 98.79% of cases after 4 weeks. Relapse incidence was 32.55% long-term, with predominantly mild adverse effects like infections and cushingoid facies.
- The regimen proved efficient in inducing and maintaining remission with a lower incidence of serious adverse effects.
Impact:
- The findings support the use of a 4-month prednisone regimen as an effective and safer treatment option for pediatric nephrotic syndrome.
- This study provides valuable data for optimizing corticosteroid therapy in children, potentially reducing long-term complications.
- Highlights the possibility of achieving sustained remission with a shorter, well-tolerated corticosteroid course.
Abstract:
In children, the nephrotic syndrome is usually corticoid-responsive; approximately 70% of patients experience relapses, frequently triggered by infections. Our paper presents the results obtained using a 4 month prednisone regimen. This retrospective study included 83 children afflicted with nephrotic syndrome over a 10 year span. We analyzed: age at diagnosis, boys/girls ratio, response to corticoid treatment - after one month of prednisone and at the completion of the treatment course, number of relapses and their frequency, complications of prednisone treatment. The median age at diagnosis was 4.8 years, males predominating M:F = 1.5:1. Complete response after 4 weeks of prednisone therapy was noted in 98.79% of cases. We had 116 episodes of relapses during the first year of follow-up, occurring in 67.4% of children (27.9% were frequent relapsers, 11.62% subsequently became corticoid-dependent). Late relapses, after the first year, occurred in 32.55% of cases. We noted mostly mild adverse effects of the prednisone treatment: occurrence of infections during therapy (16.27%), cushingoid facies (37.2%), hirsutism (4.6%), high blood pressure (4.65%), stretch marks (2.32%). In conclusion, the 4 month prednisone treatment regimen is efficient in inducing and maintaining a remission. The incidence of relapses is 32.55%, comparable to the figure cited in larger studies. Serious adverse effects are significantly lower with this regimen compared to other corticoid treatment schemes. Key wo
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