Adult-onset nephrotic syndrome with minimal changes: response to corticosteroids and cyclophosphamide

Eighty-nine patients with onset of nephrotic syndrome over the age of 15 years and minimal changes on renal biopsy have been studied. Seventy-five patients were given a course of prednisone in an initial dosage of 60mg/24hr, tapering over the following 8-16 weeks. Only 45 were in remission after eight week's treatment, 55 after 16 weeks; eventually, a total of 58 lost their proteinuria completely. Of these, 24 per cent never relapsed, 56 per cent relapsed on a single occasion or infrequently, and only 21 per cent were frequent relapsers. Cyclophosphamide, used in 36 patients, had a similar time to response. Stability of remission was better than in similar children, 66 per cent being in remission at five years, after which no further relapses were seen.