How Long Should We Treat the Initial Episode of Childhood Nephrotic Syndrome?

Although 90% of children with idiopathic nephrotic syndrome respond to prednisolone, the length of treatment for the initial episode has remained a matter of debate. These researchers conducted a controlled, double-blind, randomized, multicenter trial in the U.K. to compare the clinical response and stability of remission after either 8 or 16 weeks of prednisolone in 223 children with an initial episode of nephrotic syndrome (age range, 1–14 years; mean age, 4.9 years).

Both treatment regimens started with 60 mg/m² daily for 4 weeks (to verify steroid sensitivity). Then, the shorter regimen provided 40 mg/m² on alternate days for 4 weeks, followed by placebo, whereas the extended treatment involved 60 mg/m² on alternate days with doses taper…