Treatment outcome using prednisone in corticosteroid-responsive primary nephrotic syndrome in children

• Published in: Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi Vol. 109; no. 3; p. 492
• Main Authors: Brumariu, O, Cucer, Florentina, Munteanu, Mihaela, Haliţchi, Codruţa, Müller, R, Russu, R
• Format: Journal Article
• Language: Romanian, Moldovan
• Published: Romania 01-07-2005
• Subjects: Adolescent; Child; Child, Preschool; Female; Glucocorticoids - adverse effects; Glucocorticoids - therapeutic use; Humans; Infant; Male; Nephrotic Syndrome - complications; Nephrotic Syndrome - diagnosis; Nephrotic Syndrome - drug therapy; Prednisone - adverse effects; Prednisone - therapeutic use; Retrospective Studies; Secondary Prevention; Treatment Outcome
• ISSN: 0048-7848

In children, the nephrotic syndrome is usually corticoid-responsive; approximately 70% of patients experience relapses, frequently triggered by infections. Our paper presents the results obtained using a 4 month prednisone regimen. This retrospective study included 83 children afflicted with nephrotic syndrome over a 10 year span. We analyzed: age at diagnosis, boys/girls ratio, response to corticoid treatment - after one month of prednisone and at the completion of the treatment course, number of relapses and their frequency, complications of prednisone treatment. The median age at diagnosis was 4.8 years, males predominating M:F = 1.5:1. Complete response after 4 weeks of prednisone therapy was noted in 98.79% of cases. We had 116 episodes of relapses during the first year of follow-up, occurring in 67.4% of children (27.9% were frequent relapsers, 11.62% subsequently became corticoid-dependent). Late relapses, after the first year, occurred in 32.55% of cases. We noted mostly mild adverse effects of the prednisone treatment: occurrence of infections during therapy (16.27%), cushingoid facies (37.2%), hirsutism (4.6%), high blood pressure (4.65%), stretch marks (2.32%). In conclusion, the 4 month prednisone treatment regimen is efficient in inducing and maintaining a remission. The incidence of relapses is 32.55%, comparable to the figure cited in larger studies. Serious adverse effects are significantly lower with this regimen compared to other corticoid treatment schemes. Key wo