Clinical effect of different prednisone regimens in the treatment of children with primary nephrotic syndrome and risk factors for recurrence.
10.7499/j.issn.1008-8830.2203029
- Author:
Hai-Yun GENG
1
;
Chao-Ying CHEN
1
;
Juan TU
1
;
Hua-Rong LI
1
;
Pei-Wei DU
1
;
Hua XIA
1
;
Xiao-Ning YU
1
Author Information
1. Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing l00020, China (Chen C, Email: chenchaoying484@126. com).
- Publication Type:Journal Article
- Keywords:
Child;
Prednisone;
Primary nephrotic syndrome;
Recurrence
- MeSH:
Child;
Glucocorticoids;
Humans;
Nephrotic Syndrome;
Prednisone;
Prospective Studies;
Recurrence;
Risk Factors
- From:
Chinese Journal of Contemporary Pediatrics
2022;24(8):853-857
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:To study the clinical effect of full-dose prednisone for 4 or 6 weeks in the treatment of children with primary nephrotic syndrome and its effect on recurrence.
METHODS:A prospective non-randomized controlled clinical trial was performed on 89 children who were hospitalized and diagnosed with incipient primary nephrotic syndrome from December 2017 to May 2019. The children were given prednisone of 2 mg/(kg·day) (maximum 60 mg) for 4 weeks (4-week group) or 6 weeks (6-week group), followed by 2 mg/(kg·day) (maximum 60 mg) every other day for 4 weeks and then a gradual reduction in dose until drug withdrawal. The children were regularly followed up for 1 year. The two groups were compared in terms of the indices including remission maintenance time and recurrence rate. A Cox regression analysis was used to assess the risk factors for recurrence.
RESULTS:Within 3 months after prednisone treatment, the 4-week group had a significantly higher recurrence rate than the 6-week group (P<0.05). After 1-year of follow-up, there was no significant difference between the two groups in the recurrence rate, remission maintenance time, and recurrence frequency (P>0.05). The risk of recurrence increased in children with an onset age of ≥6 years or increased 24-hour urinary protein (P<0.05).
CONCLUSIONS:For the treatment of incipient primary nephrotic syndrome, full-dose prednisone regimen extended from 4 weeks to 6 weeks can reduce recurrence within 3 months. The children with an onset age of ≥6 years or a high level of urinary protein should be taken seriously in clinical practice, and full-dose prednisone treatment for 6 weeks is recommended to reduce the risk of recurrence.
