Longer Initial Prednisolone Treatment of Nephrotic Syndrome Is Not Better

Investigators from multiple institutions in the United Kingdom conducted a randomized controlled trial to compare the effectiveness of a prolonged tapering regimen of prednisolone to the standard regimen in childhood nephrotic syndrome. Study participants were children 1–14 years old with their first episode of steroid-sensitive nephrotic syndrome. Eligibility requirements included a ratio of first morning urine protein (or albumin) to creatinine >200 mg/mmol, serum or plasma albumin level <25 g/L, and no previous treatment with corticosteroids. All study patients were treated with prednisolone 60 mg/m² daily for 4 weeks at which point they were randomized …