Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children

1993 ◽  
Vol 152 (4) ◽  
pp. 357-361 ◽  
Author(s):  
J. H. H. Ehrich ◽  
J. Brodehl ◽  
Keyword(s):  
Nephrotic Syndrome ◽  
Initial Treatment ◽  
Idiopathic Nephrotic Syndrome ◽  
Prednisone Therapy

scholarly journals LOWERED INCIDENCE OF RELAPSE IN IDIOPATHIC NEPHROTIC SYNDROME (INS) AFTER ONE YEAR OF INTERMITTENT PREDNISONE THERAPY

1974 ◽  
Vol 8 (4) ◽  
pp. 458-458
Author(s):  
R Winston Lutz ◽  
Bahmin Shahin ◽  
Zoe Papadopoulou ◽  
Leticia Tina ◽  
Pedro Jose ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Prednisone Therapy ◽  
One Year

scholarly journals Early discharge after the initial treatment for pediatric idiopathic nephrotic syndrome

2016 ◽  
Vol 29 (2) ◽  
pp. 161-165
Author(s):  
Masaki Fuyama ◽  
Koichi Kamei ◽  
Zentaro Kiuchi ◽  
Masaki Takahashi ◽  
Mai Sato ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Initial Treatment ◽  
Idiopathic Nephrotic Syndrome ◽  
Early Discharge

scholarly journals Initial treatment of steroid-sensitive idiopathic nephrotic syndrome in children with mycophenolate mofetilversusprednisone: protocol for a randomised, controlled, multicentre trial (INTENT study)

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e024882 ◽  
Author(s):  
Rasmus Ehren ◽  
Marcus R Benz ◽  
Jorg Doetsch ◽  
Alexander Fichtner ◽  
Jutta Gellermann ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Mycophenolate Mofetil ◽  
Initial Treatment ◽  
Multicentre Trial ◽  
Idiopathic Nephrotic Syndrome ◽  
First Episode ◽  
High Dose ◽  
Study Results ◽  
Steroid Sensitive ◽  
Randomised Controlled

IntroductionIdiopathic nephrotic syndrome is the most common glomerular disease in childhood with an incidence of 1.8 cases per 100 000 children in Germany. The treatment of the first episode implies two aspects: induction of remission and sustainment of remission. The recent Kidney Disease Improving Global Outcomes, American Academy of Pediatrics and German guidelines for the initial treatment of the first episode of a nephrotic syndrome recommend a 12-week course of prednisone. Despite being effective, this treatment is associated with pronounced glucocorticoid-associated toxicity due to high-dose prednisone administration over a prolonged period of time. The aim of the INTENT study (Initial treatment of steroid-sensitive idiopathic nephrotic syndrom in children with mycophenolate mofetil versus prednisone: protocol for a randomised, controlled, multicentre trial) is to show that an alternative treatment regimen with mycophenolic acid is not inferior regarding sustainment of remission, but with lower toxicity compared with treatment with glucocorticoids only.Methods and designThe study is designed as an open, randomised, controlled, multicentre trial. 340 children with a first episode of steroid-sensitive nephrotic syndrome and who achieved remission by a standard prednisone regimen will be enrolled in the trial and randomised to one of two treatment arms. The standard care group will be treated with prednisone for a total of 12 weeks; in the experimental group the treatment is switched to mycophenolate mofetil, also for a total of 12 weeks in treatment duration. The primary endpoint is the occurrence of a treated relapse within 24 months after completion of initial treatment.Ethics and disseminationEthics approval for this trial was granted by the ethics committee of the Medical Faculty of the University of Heidelberg (AFmu-554/2014). The study results will be published in accordance with the Consolidated Standards of Reporting Trials statement and the Standard Protocol Items: Recommendations for Interventional Trials guidelines. Our findings will be submitted to major international paediatric nephrology and general paediatric conferences and submitted for publication in a peer-reviewed, open-access journal.Trial registration numberDRKS0006547; EudraCT2014-001991-76; Pre-result.Date of registration30 October 2014; 24 February 2017.

scholarly journals Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome

2016 ◽  
Vol 45 (2) ◽  
pp. 55 ◽  
Author(s):  
Ninik Asmaningsih ◽  
Windhu Poernomo ◽  
M Sjaifullah Noer
Keyword(s):  
Nephrotic Syndrome ◽  
Immunoglobulin E ◽  
Idiopathic Nephrotic Syndrome ◽  
Steroid Resistance ◽  
Protein Loss ◽  
Immune Disorder ◽  
Prednisone Therapy ◽  
Serum Ige ◽  
Filtration Barrier ◽  
History Of

Background Children with idiopathic nephrotic syndrome (INS)have been known to have T-cell dysfunction and an impairment ofthe cytokine network that may alter glomerular permeability andthe glomerular filtration barrier. This disorder may contribute to thepresence of urinary protein loss in children with INS. The elevationof serum IgE levels has been noted in some cases, but its associa-tion with steroid-responsive nephrotic syndrome has not been fullyelucidated.Objective This study was done to investigate the association be-tween serum IgE levels prior to prednisone treatment in childrenwith INS and the outcome of treatment.Methods A prospective observational study has been conductedon 22 children with INS. Prednisone therapy was given with a doseof 60 mg/m 2 body surface area (BSA) for four weeks followed by asingle dose of 40 mg/m 2 BSA every other day for another fourweeks. This protocol was applied for steroid-responsive INS chil-dren. Children with steroid resistance were given oral cyclophos-phamide 2 mg/kg for eight weeks. IgE level measurements wereperformed prior to prednisone therapy and at remission. Data wereanalyzed using one-way ANOVA and multiple regression.Results Twenty-two children were enrolled in this study. High lev-els of serum IgE were found in 95.5% of children, with a mean of2002.5 (SD 2172.1) IU/ml. The serum IgE levels of INS childrenwith history of allergy were significantly higher than those of neph-rotic children without history of allergy (P<0.05). However, therewas no significant correlation between the serum IgE levels andthe outcome of treatment in children with INS.Conclusion The high serum IgE levels in children with INS seemto be associated with humoral immune disorder and did not haveany association with the outcome of therapy. Even though the se-rum IgE levels were significantly higher in INS children with historyof allergy, other factors that may influence serum IgE levels mustbe considered

RNA expression as a prognostic tool in idiopathic nephrotic syndrome

2007 ◽  
Vol 148 (23) ◽  
pp. 1067-1075
Author(s):  
Krisztina Fischer ◽  
Orsolya Galamb ◽  
Béla Molnár ◽  
Zsolt Tulassay ◽  
András Szabó
Keyword(s):  
Nephrotic Syndrome ◽  
Northern Blot ◽  
Idiopathic Nephrotic Syndrome ◽  
Minimal Change ◽  
Ribonuclease Protection Assay ◽  
Rna Expression ◽  
Rt Pcr ◽  
Protection Assay ◽  
Ribonuclease Protection

A gyermekkori nephrosis 90%-a idiopathiás nephrosis szindróma. Az idetartozó három kórkép, a minimal change betegség, a mesangialis proliferatio és a focalis sclerosis hasonló klinikai képpel jelentkező, eltérő prognózisú és terápiás válaszú betegség. Dolgozatunk célja az idiopathiás nephrosis szindrómába tartozó kórképek kialakulásával, progressziójával összefüggő genetikai ismeretek, génexpressziós változások áttekintése és funkcionális csoportosítása. A génexpressziós változások meghatározásának eszközeként, dolgozatunk röviden összefoglalja a northern blot, a ribonuclease protection assay, az in situ RNS-hibridizáció, a kvantitatív RT-PCR és a microarray módszerek lényegét. Az eddig elvégzett vizsgálatok a DNS-szintézis és repair gének, növekedési faktorok, extracelluláris mátrix, extracelluláris ligandreceptorok, extracelluláris jelátvitel zavarai mellett kiemelik a metabolikus és transzporter gének, illetve az immunszabályozó gének molekuláris eltéréseit, amelyek összefüggésben vannak az idiopathiás nephrosis szindróma eddig megismert molekuláris hátterével. A chiptechnológia fejlődésével és elterjedésével ezek a markerek és a hagyományos vizsgálati módszerek párhuzamos alkalmazása rutindiagnosztikai szempontból is fontossá válhat.

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