Two dosing regimens for steroid therapy in nephrotic syndrome

Abstract

regimen depended on the treating physician. The age of the children at onset varied from 1.0 to 11.4 (median 4.0) years. Although there were no significant differences between the two groups in terms of gender ratio, age, serum albumin at onset, time to response to initial therapy, or proportion of adverse events, the onset time for relapses after initial therapy was significantly shorter for children in the BW-based dosing group than for those in the BSA-based group (2.0 vs. 6.0 months; p<0.05). Further, the proportion of steroiddependent NS was also significantly higher among children in the BW-based dosing group than among those in the BSA-based group (53.3 vs. 12.5 %; p<0.05). Our study, although retrospective in nature, indicates that for children with idiopathic NS, BW-based and BSA-based steroid dosing are not equivalent if the child’s BW is <30 kg. In conclusion, our findings are in agreement with the simulation study by Saadeh et al. [1] that BW-based dosing might lead to “underdosing.” Based on our retrospective analysis, we would like comment that in order to enable accurate comparisons between trials, consistent dosing regimens should be used in future trials involving children with idiopathic NS.