Trial reportArchives of disease in childhood2007
Adrenocortical suppression increases the risk of relapse in nephrotic syndrome.
Trial report in Archives of disease in childhood, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Steroid-induced adrenal insufficiency in children with nephrotic syndrome: a systematic review.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Efficacy of low-dose daily versus alternate-day prednisolone in frequently relapsing nephrotic syndrome: an open-label randomized controlled trial.Pediatric nephrology (Berlin, Germany) · 2019Trial
- Short courses of daily prednisolone during upper respiratory tract infections reduce relapse frequency in childhood nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2017Trial
- Prevalence, risk factors, and the screening value of basal cortisol for adrenal insufficiency after corticosteroid therapy in children with idiopathic nephrotic syndrome.Clinical and experimental nephrology · 2026Article
- Adrenal Insufficiency in Children With Nephrotic Syndrome Treated With High Doses of Glucocorticoids.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Impact of glucocorticoid therapy on hypothalamic-pituitary-adrenal axis function in pediatric nephrotic syndrome: A narrative review.World journal of clinical pediatrics · 2025Review
- Optimal functioning of hypothalamic-pituitary-adrenal axis after cessation of prednisolone therapy: a cross-sectional study in children with nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2025Article
- Adrenocortical suppression in children with nephrotic syndrome treated with corticosteroids.Pediatric nephrology (Berlin, Germany) · 2024Article
- Podocyte number and glomerulosclerosis indices are associated with the response to therapy for primary focal segmental glomerulosclerosis.Frontiers in medicine · 2024Article
- Article
- Optimizing the corticosteroid dose in steroid-sensitive nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2022Review
- Podocytopathies.Nature reviews. Disease primers · 2020Review
- Adrenal Insufficiency in Children With Nephrotic Syndrome on Corticosteroid Treatment.Frontiers in pediatrics · 2020Article
- The non-immunosuppressive management of childhood nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2016Review
- Adrenal Insufficiency after Steroid Therapy in Children with Steroid-Sensitive Nephrotic Syndrome: A Cross-sectional Study.Indian journal of endocrinology and metabolismArticle
- Adrenocortical Suppression in Children with Nephrotic Syndrome Treated with Low-Dose Alternate Day Corticosteroids.Indian journal of nephrologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveChildren with nephrotic syndrome (NS) are usually treated with long-term low dose alternate day prednisolone with or without glucocorticoid sparing therapy, such as levamisole or ciclosporin, to maintain remission. The degree of hypothalamic-pituitary-adrenal axis (HPA) suppression with such therapeutic strategies has not been studied systematically. HPA suppression could cause a relapse or adrenal crisis. STUDY
designTo study the risks of HPA suppression, a modified low dose synacthen test (0.5 mug) was administered to 32 patients (22 male,10 female) with a mean age of 9.7 years (range 3.8-17.6 years) with NS receiving long-term alternate day prednisolone for over 12 months. Twelve patients received alternate day prednisolone, 11 alternate prednisolone+levamisole and nine alternate prednisolone+ciclosporin. All patients were followed up for 3 years and the relapse rate noted.
results20/32 (62.5%) patients had a peak serum cortisol concentration of <500 nmol/l, which suggested suboptimal cortisol secretion and possible HPA suppression. 10/12 children in the prednisolone group and 8/11 in the levamisole group had a suboptimal cortisol response compared with 2/9 in the ciclosporin group. During follow-up, the 20 children who had a suboptimal cortisol response had significantly more relapses (95 relapses) compared to the 12 children with a normal cortisol response who had 24 relapses (p = 0.01).
conclusionsChildren with NS receiving long-term alternate day prednisolone therapy are at risk of developing HPA suppression and should be evaluated using the modified synacthen test. Children with evidence of HPA suppression are at a greater risk of relapse.
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