Association of postmedication hypocortisolism with early first relapse of idiopathic nephrotic syndrome

A 2-hour adrenocorticotrophic-hormone (A.C.T.H.) test was given to 23 children in their first attack of idiopathic nephrotic syndrome, after treatment with prednisone according to the schedule of the International Study of Kidney Disease in Children. The length of the first remission was correlated with the response to the postmedication A.C.T.H. test. In 11 children this response was subnormal, and 10 of them had the first relapse within a year. Of the 7 children who stayed in remission for more than a year, 6 had normal responses. The treatment scheme should be adjusted to prevent postmedication adrenocortical suppression.