Cochrane Library: Corticosteroids for nephrotic syndrome in children
Nephrotic syndrome is a chronic kidney condition that causes leakage of protein through the kidney to cause widespread tissue edema and increased thrombotic and infectious complications. Most children who develop the nephrotic syndrome experience prompt disease remission with corticosteroid therapy (prednisone or prednisolone) although about 80% of children will experience one or more disease relapses and these relapses can continue into their adult life. Corticosteroid therapy is highly effective at inducing remission but has important negative implications for child health including slowed growth, obesity, impaired psychological well-being and longer term cardiovascular risk. The optimal dose and duration of corticosteroid therapy for children with nephrotic syndrome is uncertain because existing trials provide different results. In this Cochrane review from 2015, prednisone given for 2-3 months was as effective as longer term treatment (6 months) for preventing relapsing disease in children who have their first episode of nephrotic syndrome. Children with relapsing disease benefited from 5-7 days of daily prednisone therapy given at the time of an infection. The side effects of different treatment regimens are poorly understood.
Dee is a senior nephrologist based at The Childrens Hospital at Westmead in Sydney. The nephrology department at The Childrens Hospital is a major Australian center for children with kidney disorders including glomerulonephritis.
Elisabeth Hodson is Emeritus Consultant Physician in Paediatric Nephrology at the Childrens Hospital at Westmead in Sydney, Australia. She is an editor for Cochrane Kidney and Transplant and has written several Cochrane reviews.
Copyright© 2016 Cochrane Kidney and Transplant. Published by John Wiley & Sons, Ltd.