Details

Autor(en) / Beteiligte

• Pańczyk-Tomaszewska, Małgorzata
• Skrzypczyk, Piotr
• Mroczkowski, Kacper
• Leszczyńska, Beata
• Mizerska-Wasiak, Małgorzata

Titel

Treatment of idiopathic nephrotic syndrome with two steroid dosing regimens - one-year observational study

Ist Teil von

• Central-European journal of immunology, 2021-01, Vol.46 (3), p.344-350

Ort / Verlag

Poland: Termedia Publishing House

Erscheinungsjahr

2021

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• The aim of the study was to compare the first year of disease in children with idiopathic nephrotic syndrome (INS) treated according to two prednisone dosing regimens: a weight-based schedule (2 mg/kg/24 h in the 1 month, 2 mg/kg/48 h in the 2 month, with dose tapering during the following 4 months), and a body surface area (BSA)-based schedule (60 mg/m /24 h in the 1 month, 40 mg/m /48 h in the 2 month, with dose tapering during the following 4 months). In 2 groups of children treated with weight- and BSA-based regimens (20 patients, 3.13 ±1.01 years, treated in 2010-2013 and 20 patients, 5.13 ±2.86 years, treated in 2014-2016) clinical and anthropometrical parameters, number of INS relapses, total prednisone dose (mg/kg/year), and steroid adverse effects were compared during the first year of disease. Children treated with the weight-based steroid regimen received a higher total annual prednisone dose (259.06 ±79.54 vs. 185.83 ±72.67 mg/kg/24 h, p = 0.004) and had a shorter (though not significantly) period without prednisone (38.25 ±55.83 vs. 75.90 ±73.06 days, p = 0.062) compared to patients treated with the BSA-based regimen. There was no difference in number of relapses between groups (2.20 ±1.64 vs. 1.60 ±1.67, p = 0.190) but more patients relapsed in the weight-based group (19/20 vs. 13/20, p = 0.044). No differences in Z-score values of height, weight, and body mass index (BMI) were observed. No steroid-related adverse events were noted except for arterial hypertension (4/20 vs. 5/20 patients, p = 1.000). The BSA-based regimen of prednisone dosing in children with INS reduces exposure to steroids and risk of relapse, as well as increases days off steroids in the first year compared to the weight-based regimen with a high second-month dose.