Full Dose Steroid Responsiveness Within 8 Weeks in Initial Treatment of Childhood Nephrotic Syndrome

Objective: To determine the steroid responsiveness within 8 weeks of the initial treatment of childhood nephrotic syndrome. Patients and Methods: This prospective study was conducted in Children Hospital, Pakistan Institute of Medical Sciences, Islamabad from January 2012 to June 2012. A total of 139 children aged 1 to 10 years of both genders diagnosed as nephrotic syndrome were included in the study. Those children who were already taking any form of therapy for Nephrotic syndrome were excluded from the study. These children were given prednisolone 60 mg/m2 of body surface area, divided into 3 doses for a period of 8 weeks and then switched over to 40 mg/m2 as a single morning dose on alternate days, in those children who showed a response. The primary outcome of the study was to see the response of steroid therapy at different occasions for up to 8 weeks. SPSS version 11.0 was used for data analysis. Mean and standard deviation were calculated for numerical variables and frequency and percentages were calculated for categorical variables. Results: In this study 16.5% of cases responded to steroids within 2 weeks, major bulk of patients (43.5%) showed response between 3-4 weeks, (20.1%) and (2.1%) patients responded between 5-6 weeks and 7-8 weeks respectively. Steroid resistant nephrotic syndrome was seen in 16% of the study cases. Conclusion: Steroids are first line treatment for the idiopathic nephrotic syndrome. The majority of the patients show a response within 8 weeks of their first presentation. Maximum number responds between 3-4 weeks