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Submitted: 03 Jan 2020
Accepted: 25 Mar 2020
ePublished: 10 Apr 2020
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J Renal Inj Prev. 2020;9(3): e25.
doi: 10.34172/jrip.2020.25
  Abstract View: 105
  PDF Download: 57

Original

Comparison of eight-week and twelve-week corticosteroid treatment regimens in children with idiopathic nephrotic syndrome; A clinical trial

Hossein Emad Momtaz 1 * ORCID logo, Amin al Sadat Sharif 2, Ali Amri 3 ORCID logo

1 Division of Pediatric Nephrology, Besat Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2 Division of Pediatric Nephrology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
3 School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
*Corresponding author: Hossein Emad Momtaz, Email: hemmtz@yahoo.com

Abstract

Introduction: Nephrotic syndrome (NS) is the commonest chronic glomerular disease in children. Idiopathic NS can perfectly be controlled using corticosteroids in most instances, but a significant relapse rate of NS is still a major problem. Several treatment protocols are suggested to decrease relapse rate of NS in children.

Objectives: The current clinical trial aimed at comparing the relapse rate between two 8- and 12-week steroid treatment regimens.

Patients and Methods: In the current non-randomized, clinical trial, a total of 68 children with primary NS were enrolled. Oral prednisolone was administered to 34 patients for eight weeks (2 mg/kg/d and 1.5 mg/kg/alternate-day/each for four weeks) and other 34 patients for 12 weeks (2 mg/kg/d and 1.5 mg/kg/alternate-day/each for six weeks). A one-year followup was completed for all the patients to evaluate relapse rate, steroid resistance, and steroid dependence.

Results: The remission rates were 47.1% and 73.5%, respectively in children of the eight- and 12-week treatment groups because the difference was significant (P=0.026). The frequent relapse rates in the eight- and 12-week treatment groups were respectively 26.5% and 11.8%. Steroid dependence rate was 17.6% and 8.8% in the eight- and 12-week treatment groups respectively. The steroid resistance rates were respectively 8.8% and 5.9% in the eight- and 12-week treatment groups.

Conclusion: Twelve-week steroid treatment can significantly decrease the relapse rate in comparison with eight-week treatment because no significant difference in steroid resistance, steroid dependence, and frequent relapse between the two treatment protocols was observed.

Keywords: Nephrotic syndrome, Children, Treatment

Implication for health policy/practice/research/medical education:

In a non-randomized, clinical trial to compare eight-week versus twelve-week corticosteroid treatment regimens in children with idiopathic nephrotic syndrome, we found twelve-week steroid treatment could significantly decrease the relapse rate in comparison with eight-week treatment because no significant difference in steroid resistance, steroid dependence, and frequent relapse between the two treatment protocols was observed.

Please cite this paper as: Emad Momtaz H, Al Sadat Sharif A, Amri A. Comparison of eight-week and twelve-week corticosteroid treatment regimens in children with idiopathic nephrotic syndrome; A clinical trial. J Renal Inj Prev. 2020; 9(3): e25. doi: 10.34172/jrip.2020.25.

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