Prolonged Initial Phase Tapering Prednisolone Therapy In Nephrotic Syndrome
Keywords:
Nephrotic Syndrome, Prolonged Steroid TherapyAbstract
Objective: To assess the prospects of maintaining a sustained remission by prolonged initial phase steroid therapy in nephrotic syndrome.
Design: Hospital based descriptive study.
Place and Duration: Department of Pediatric Medicine, Combined Military Hospital, Lahore, Pakistan. January 2002 to January 2010.
Patients and Methods: Fifty children of both genders in their very first episode of steroid sensitive nephrotic syndrome (SSNS) were selected after an informed parental consent. Prednisolone was used in a gradually tapering dose spread over 7 months with a post-treatment 12-month follow up. Albuminuria was monitored by dipstick method.
Results: Thirty five (70%) boys and 15 (30%) girls participated in the study with male to female ratio of 2.3:1. Mean age was 4.62±2.15 years. All the patients became albuminuria-free within first 4 weeks of treatment. Thirty two (64%) patients maintained remission during the study and 12-month follow-up period. Eighteen (36%) case relapsed within 6 months after completion of initial treatment. Eight (16%) of these 18 cases had multiple relapses. Cushingoid appearance and mild hypertrichosis was noted in all the 50 (100%) cases.
Conclusion: Prolonged initial phase tapering steroid therapy helps maintain a sustained and longer remission in SSNS. It should be adopted as the standard regimen.
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