[Glucocorticoid therapy for children with idiopathic nephrotic syndrome].

The glucocorticoid treatment of patients with idiopathic nephrotic syndrome in children was reported especially focused upon the dose of initial treatment and different effect of various glucocorticoids if they were used equivalently. It appeared that lower dose prednisolone; 40 mg/m2 bsa (body surface area) was also effective same as 60 mg/m2 bsa of protocol of ISKDC (International Study of Kidney Disease in Children) for the initial treatment if time for free proteinuria was taken as index. Therefore, it was considered favorable that we could use lower dose to avoid various adverse effects of glucocorticoids. Clinically it was felt that some different effects were present despite of their equivalent use. The equivalency of various glucocorticoids was based upon anti-inflammatory effect experimentally. The etiology of idiopathic nephrotic syndrome has not been well known, however some sort of immune disorder has been thought most important. Therefore, it might be acceptable if effect of glucocorticoid treatment of nephrotic syndrome is evaluated on the basis of immunosuppression. It is hoped that these empirically proven evidence should be analysed fundamentally in the near future.