The Journal of Pediatrics
Volume 156, Issue 6 , Pages 965-971 , June 2010

Time for Initial Response to Steroids Is a Major Prognostic Factor in Idiopathic Nephrotic Syndrome

  • Marina Vivarelli, MD

      Affiliations

    • Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
    • ,
  • Eleonora Moscaritolo, MD

      Affiliations

    • Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
    • ,
  • Aggelos Tsalkidis, MD

      Affiliations

    • Department of Pediatrics, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, Alexandroupolis, Greece
    • ,
  • Laura Massella, MD

      Affiliations

    • Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
    • ,
  • Francesco Emma, MD

      Affiliations

    • Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy

Received 6 August 2009 ,Revised 14 October 2009 ,Accepted 10 December 2009.

References 

  1. Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003;362:629–639
  2. Hodson EM, Willis NS, Craig JC. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev. 2007;CD001533
  3. Ehrich JH, Geerlings C, Zivicnjak M, Franke D, Geerlings H, Gellermann J. Steroid-resistant idiopathic childhood nephrosis: overdiagnosed and undertreated. Nephrol Dial Transplant. 2007;22:2183–2193
  4. The primary nephrotic syndrome in children. Identification of patients with minimal change nephrotic syndrome from initial response to prednisone. A report of the International Study of Kidney Disease in Children. J Pediatr. 1981;98:561–564
  5. Niaudet P, Habib R. Cyclosporine in the treatment of idiopathic nephrosis. J Am Soc Nephrol. 1994;5:1049–1056
  6. Letavernier B, Letavernier E, Leroy S, Baudet-Bonneville V, Bensman A, Ulinski T. Prediction of high-degree steroid dependency in pediatric idiopathic nephritic syndrome. Pediatr Nephrol. 2008;23:2221–2226
  7. Yap HK, Han EJ, Heng CK, Gong WK. Risk factors for steroid dependency in children with idiopathic nephrotic syndrome. Pediatr Nephrol. 2001;16:1049–1052
  8. Constantinescu AR, Shah HB, Foote EF, Weiss LS. Predicting first-year relapses in children with nephrotic syndrome. Pediatrics. 2000;105:492–495
  9. Arneil GC, Lam CN. Long-term assessment of steroid therapy in childhood nephrosis. Lancet. 1966;2:819–821
  10. Mekahli D, Liutkus A, Ranchin B, Yu A, Bessenay L, Girardin E, et al. Long-term outcome of idiopathic steroid-resistant nephrotic syndrome: a multicenter study. Pediatr Nephrol. 2009;24:1525–1532
  11. Meyrier A. Mechanisms of disease: focal segmental glomerulosclerosis. Nat Clin Pract Nephrol. 2005;1:44–54
  12. Early identification of frequent relapsers among children with minimal change nephrotic syndrome. A report of the International Study of Kidney Disease in Children. J Pediatr. 1982;101:514–518
  13. Tarshish P, Tobin JN, Bernstein J, Edelmann CM. Prognostic significance of the early course of minimal change nephrotic syndrome: report of the International Study of Kidney Disease in Children. J Am Soc Nephrol. 1997;8:769–776
  14. Ehrich JH, Brodehl J. Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children. Arbeitsgemeinschaft für Pädiatrische Nephrologie. Eur J Pediatr. 1993;152:357–361
  15. Hoyer PF, Brodeh J. Initial treatment of idiopathic nephrotic syndrome in children: prednisone versus prednisone plus cyclosporine A: a prospective, randomized trial. J Am Soc Nephrol. 2006;17:1151–1157

 Supported by the E-RARE Project “PodoNet: EU Consortium for Clinical, Genetic and Experimental Research into Hereditary Diseases of the Podocyte.” The authors declare no conflicts of interest

PII: S0022-3476(09)01249-9

doi: 10.1016/j.jpeds.2009.12.020

The Journal of Pediatrics
Volume 156, Issue 6 , Pages 965-971 , June 2010

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