Extending steroid treatment does not benefit children with hard-to-treat kidney disease
Extending steroid treatment for the most common form of kidney disease in children provides no benefit for preventing relapses or side effects, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings challenge previous assumptions about optimal treatment strategies for this disease.
Nephrotic syndrome is the most common kidney disease in childhood. Children with the disease are at risk of developing severe infections and other complications because their kidneys leak important proteins from the blood into the urine. Their bodies also retain water, which results in general discomfort and abdominal pain. Steroids such as prednisolone induce remission in 90-95% of patients; however relapses occur in 60-90% of initial responders. Prolonged prednisolone treatment for initial episodes of childhood nephrotic syndrome may reduce the relapse rate (despite potentially causing serious side effects), but whether this results from an increased duration of treatment or from a higher cumulative dose remains unclear.
To investigate, Nynke Teeninga, MD (Erasmus University Medical Centre at Sophia Children's Hospital, in Rotterdam, the Netherlands) and her colleagues conducted a randomized, double-blind, placebo-controlled trial in 69 hospitals in the Netherlands. They assigned 150 children (nine months to 17 years old) with nephrotic syndrome to either three months of prednisolone followed by three months of placebo or to six months of prednisolone. Patients were followed for an average of 47 months. Both groups received equal cumulative doses of prednisolone (approximately 3360 mg/m2).
- Among the 126 children who started taking medication, relapses occurred in 48 (77%) of the 62 patients who received three months of prednisolone and in 51 (80%) of the 64 who received six months of prednisolone.
- Frequent relapses occurred with similar frequency between groups as well (45% vs 50%).
- There were no statistically significant differences between groups with respect to the eventual initiation of prednisolone maintenance and/or other immunosuppressive therapy (50% vs 59%), steroid dependence, or side effects.
Dr. Teeninga added that because many children with nephrotic syndrome face frequent relapses, future research should focus on preventing relapses through new treatment strategies.
More information: The article, entitled "Extending Prednisolone Treatment Does Not Reduce Relapses in Childhood Nephrotic Syndrome," will appear online on December 20, 2012, doi: 10.1681/2012070646
Journal reference: Journal of the American Society of Nephrology
Provided by American Society of Nephrology
- Research examines effect of prednisolone in patients with Bell palsy May 21, 2012 | not rated yet | 0
- Oral steroids ineffective in the treatment of preschool virus-induced wheezing Jan 21, 2009 | not rated yet | 0
- Childhood kidney disorder has lasting effects Sep 24, 2009 | not rated yet | 0
- Immune drug doesn't help kids with hard-to-treat kidney disorder May 10, 2012 | not rated yet | 0
- Alternative treatment for preventing relapse of certain type of vasculitis appears less effective Nov 08, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
(AP)—Government health officials are investigating several health problems reported with potentially contaminated medications made by a Tennessee specialty pharmacy.
Diseases, Conditions, Syndromes 3 hours ago | not rated yet | 0
(HealthDay)—Comorbid conditions often accompany alopecia areata, according to a study published online May 22 in JAMA Dermatology.
Diseases, Conditions, Syndromes 4 hours ago | not rated yet | 0
(HealthDay)—As a world-class golfer, Stacy Lewis' accomplishments are remarkable. But it was a physical challenge in her childhood that defined her ascent to the top of her sport.
Diseases, Conditions, Syndromes 4 hours ago | not rated yet | 0
Saudi Arabia said Friday it would send samples taken from animals possibly infected with a deadly SARS-like virus to the United States for testing in a bid to find the source of disease.
Diseases, Conditions, Syndromes 7 hours ago | not rated yet | 0
The World Health Organization voiced deep concern Thursday over the SARS-like virus that has killed 22 people in less than a year, saying it might potentially spread more widely between humans.
Diseases, Conditions, Syndromes 11 hours ago | 5 / 5 (1) | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
8 hours ago | 5 / 5 (3) | 0 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
5 hours ago | 5 / 5 (1) | 0 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
6 hours ago | 5 / 5 (2) | 0 |
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
3 hours ago | 5 / 5 (1) | 0 |
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
2 hours ago | not rated yet | 0
(Medical Xpress)—Patients with diabetes who are depressed are much more likely to develop episodes of dangerously low blood sugars, or hypoglycemia, than are those who are not depressed, a new study has ...
9 hours ago | not rated yet | 0 |