24-year-old man • prednisone therapy for nephrotic syndrome • diffuse maculopapular rash • pruritis

THE AIM: to compare the parameters of physical development (PD) in children with idiopathic nephrotic syndrome (INS), depending on the treatment with prednisone.PATIENTS AND METHODS. The effect of treatment with prednisone on PD was analyzed in 60 children with INS aged from 2 to 17 years. The children were divided into 2 groups: 30 children who did not receive prednisone, and 30 children who received it during the last 6 months before the study (1st and 2nd group, respectively). The groups compared the anamnestic parameters and the risk factors of children in terms of length, weight, and body mass index.RESULTS. When comparing the characteristics of the risk factors of children of the above 2 groups, differences in body mass and BMI were established. In children who received prednisone for the last 6 months, body weight and BMI were significantly exceeded compared to WHO standards and similar patients who did not receive prednisone for the last 6 months. We have established a reliable association of the Z-BMI criterion with the cumulative dose of prednisone in the last 6 months: r = 0.49, p <0.05. At the same time, no reliable association of body weight with a cumulative dose of prednisone, which the child received before 6 months, has been identified. When analyzing the effectiveness of different doses of prednisone therapy for stopping relapses in children with steroid-sensitive INS, it was found that the onset and duration of remission did not significantly differ when taking standard (60mg/m2/day or 2 mg/kg/day) and half as much (1mg/kg/day) doses of prednisone.CONCLUSION. The relationship of the body mass of children with INS and the cumulative dose of prednisone in the last 6 months has been established. When treating a recurrent steroid-sensitive non-relapsing INS, a decrease in the daily dose of prednisone from 2 mg/kg/day to 1 mg/kg/day is possible in adolescents who are afraid of steroid obesity or who have had severe complications during previous courses of prednisone therapy.

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Relapse episodes in childhood primary nephrotic syndrome treated by alternate or three consecutive daily dose prednisone therapy

Paediatrica Indonesiana ◽

10.14238/pi48.6.2008.338-41 ◽

2016 ◽

Vol 48 (6) ◽

pp. 338

Author(s):

Denny Sujatno ◽

M. P. Damanik ◽

Purnomo Suryantoro

Keyword(s):

Nephrotic Syndrome ◽

Cohort Study ◽

Retrospective Cohort ◽

Dose Group ◽

Primary Nephrotic Syndrome ◽

Prednisone Therapy ◽

Drug Of Choice ◽

Daily Dose ◽

Consecutive Dose ◽

Dose Prednisone

Background Prednison is still the drug of choice for the treatmentof nephrotic syndrome, especially for those with minimal change.Methods of treatment to optimize the effectiveness and efficacyare still in discussion.Objectives To evaluate the episode of relapsing minimal changenephrotic syndrome patients who received prednisone therapy byalternate or by three consecutive dose methods.Methods We performed a retrospective cohort study using medicalrecords of the patients with primary nephrotic syndrome admittedto Division of Nephrology, Sardjito Hospital, Yogyakarta fromJanuary 1995 to January 2005. Subjects were divided into twogroups, the first group treated with alternate days while thesecond group with three consecutive days prednisone program.Evaluation had been done to compare both treatment program(alternate days or consecutive days).Results Relapse episodes after six month recovery periods withalternate days treatment was 33% while those with consecutivedays was as high as 83% (P>O.Ol).Conclusion Alternate dose group has a lower relapse eventcompared to three consecutive dose group in children withnephrotic syndrome.

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Comparison of Different Regimens of Prednisone Therapy in Frequently Relapsing Nephrotic Syndrome

Acta Paediatrica ◽

10.1111/j.1651-2227.1990.tb11461.x ◽

1990 ◽

Vol 79 (3) ◽

pp. 305-310 ◽

Cited By ~ 13

Author(s):

ANNE-MARGRET WINGEN ◽

DIRK E. MÜLLER-WIEFEL ◽

KARL SCHÄRER

Keyword(s):

Nephrotic Syndrome ◽

Prednisone Therapy ◽

Frequently Relapsing Nephrotic Syndrome

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Analysis of ACTH Levels After High Dose and Long-Term Prednisone Therapy in Children with Steroid Sensitive Nephrotic Syndrome

International Journal of Pharmaceutical and Clinical Research ◽

10.25258/ijpcr.v9i04.8541 ◽

2017 ◽

Vol 9 (04) ◽

Author(s):

Hapsari R N ◽

Asmaningsih N. ◽

Padolo E. ◽

Yulistiani .

Keyword(s):

Nephrotic Syndrome ◽

Hpa Axis ◽

Laboratory Data ◽

Suppressive Effect ◽

High Dose ◽

Induction Phase ◽

Prednisone Therapy ◽

Steroid Sensitive Nephrotic Syndrome ◽

Steroid Sensitive

Background The use of high dose and long-term prednisone as glucocorticoid in steroid-sensitive nephrotic syndrome patients can cause the suppressive effect on endogenous steroid production, namely HPA axis suppression which is characterized by the decrease of ACTH levels. This can decrease cortisol levels so can affect metabolism process, immune response, and brain function. Objective To analyze ACTH levels in the induction and alternating phase, and to relate with the patient’s condition both clinical and laboratory data. Methods ACTH levels were measured before and after induction phase and four weeks after alternating phase at 08.00-09.30 a.m. Results 15 patients consisted of 9 boys and 6 girls showed there were no significant differences between ACTH levels in each phase. ACTH levels were increased 23.6% from 22.2 ± 13.1 pg/mL to 27.4 ± 23.0 pg/mL during the induction phase (p>0.05) and alternating phase also showed that ACTH levels were increased 1.7% from 27.4 ± 23.0 pg/mL to 27.9 ± 22.2 pg/mL (p>0.05). The clinical manifestation of HPA axis suppression such as hypoglycemia, hypotension, weight loss, appetite loss, and acute dehydration were not found in the patients. Weakness, fatigue, nausea, vomiting, and abdominal pain were found only 7% after the induction phase. Conclusion HPA axis suppression did not occur after the high dose and long-term prednisone therapy in the induction and alternating phase which showed ACTH levels average in normal range. It was also supported by the absence of clinical and laboratory data that showed signs of HPA axis suppression.

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