Chirico Valeria, Tripodi Filippo, Conti Giovanni, Silipigni Lorena, Lacquaniti Antonio, Monardo Paolo, Chimenz Roberto
Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
Nephrology and Dialysis Unit, Papardo Hospital, 98124 Messina, Italy.
Medicina (Kaunas). 2025 Jul 11;61(7):1257. doi: 10.3390/medicina61071257.
: The nephrotic syndrome (NS) is the most common acquired childhood kidney disease. Steroids represent the cornerstone of the therapeutic strategy, representing the first-line approach, but optimal therapeutic management is debated. This study aimed to compare different steroid therapeutic management protocols. : A total of 140 NS pediatric patients were enrolled retrospectively. All the kids were divided among three different groups according to the three different steroid therapeutic schemes: 2240 mg/m (group 1), 3360 mg/m (group 2), or 3640 mg/m (group 3) and divided in frequently relapsing (FR-NS) or steroid-dependent (SD) NS. : Within group 1, 50% of the population developed FR-NS; 100% of those kids were between 2 and 6 years old. Within the second group, 54% of the patients developed FR-NS, and 83% of these kids were between 2 and 6 years old, i.e., 45% of the group population. Within group 3, 45% of the patients developed FR-NS, and 70% of these kids were among 2 and 6 years old, i.e., 32% of the group population. This group exhibits the lowest percentage (42%) of patients in the highest relapse category (≥5 relapses) compared to the other protocols, indicating that this protocol might be more effective at reducing the number of frequent relapses. No specific predictor factors of FR- or SD-NS were revealed in the studied cohort. : A longer steroid scheme does not correlate with a better outcome, nor does it reduce the number of relapses or prevent steroid failure.
肾病综合征(NS)是儿童最常见的后天性肾脏疾病。类固醇是治疗策略的基石,是一线治疗方法,但最佳治疗管理仍存在争议。本研究旨在比较不同的类固醇治疗管理方案。:共回顾性纳入140例NS儿科患者。所有儿童根据三种不同的类固醇治疗方案分为三组:2240mg/m²(第1组)、3360mg/m²(第2组)或3640mg/m²(第3组),并分为频繁复发(FR-NS)或类固醇依赖(SD)型NS。:在第1组中,50%的人群发展为FR-NS;这些儿童中有100%年龄在2至6岁之间。在第二组中,54%的患者发展为FR-NS,其中83%的儿童年龄在2至6岁之间,即占该组人群的45%。在第3组中,45%的患者发展为FR-NS,其中70%的儿童年龄在2至6岁之间,即占该组人群的32%。与其他方案相比,该组在最高复发类别(≥5次复发)中的患者百分比最低(42%),表明该方案在减少频繁复发次数方面可能更有效。在所研究的队列中未发现FR-或SD-NS的特定预测因素。:较长的类固醇方案与更好的结果无关,也不会减少复发次数或预防类固醇失效。