Trial reportJournal of the American Society of Nephrology : JASN2013
Extending prednisolone treatment does not reduce relapses in childhood nephrotic syndrome.
Trial report in Journal of the American Society of Nephrology : JASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 8 of them syntheses 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
62 citing papers in PubMed, 8 syntheses or guidelines pooled it, 137 citations in OpenAlex.
- Single-dose versus multi-dose steroid therapy in pediatric nephrotic syndrome: a systematic review and meta-analysis.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Corticosteroid therapy for nephrotic syndrome in children.The Cochrane database of systematic reviews · 2024Pooled it
- Pediatric idiopathic steroid-sensitive nephrotic syndrome: diagnosis and therapy -short version of the updated German best practice guideline (S2e) - AWMF register no. 166-001, 6/2020.Pediatric nephrology (Berlin, Germany) · 2021Guideline
- Steroid treatment for the first episode of childhood nephrotic syndrome: comparison of the 8 and 12 weeks regimen using an individual patient data meta-analysis.European journal of pediatrics · 2021Pooled it
- Corticosteroid therapy for nephrotic syndrome in children.The Cochrane database of systematic reviews · 2020Pooled it
- A PRISMA-compliant meta-analysis of MDR1 polymorphisms and idiopathic nephrotic syndrome: Susceptibility and steroid responsiveness.Medicine · 2017Pooled it
- The Italian Society for Pediatric Nephrology (SINePe) consensus document on the management of nephrotic syndrome in children: Part I - Diagnosis and treatment of the first episode and the first relapse.Italian journal of pediatrics · 2017Pooled it
- Corticosteroid therapy for nephrotic syndrome in children.The Cochrane database of systematic reviews · 2015Pooled it
- Health-related quality of life of children with first onset steroid-sensitive nephrotic syndrome.European journal of pediatrics · 2023Trial
- Low-dose versus conventional-dose prednisolone for nephrotic syndrome relapses: a randomized controlled non-inferiority trial.Pediatric nephrology (Berlin, Germany) · 2021Trial
- CyTOF-Enabled Analysis Identifies Class-Switched B Cells as the Main Lymphocyte Subset Associated With Disease Relapse in Children With Idiopathic Nephrotic Syndrome.Frontiers in immunology · 2021Trial
- Study protocol: high-dose mizoribine with prednisolone therapy in short-term relapsing steroid-sensitive nephrotic syndrome to prevent frequent relapse (JSKDC05 trial).BMC nephrology · 2018Trial
- A multicenter randomized trial indicates initial prednisolone treatment for childhood nephrotic syndrome for two months is not inferior to six-month treatment.Kidney international · 2015Trial
- Best practice guidelines for idiopathic nephrotic syndrome: recommendations versus reality.Pediatric nephrology (Berlin, Germany) · 2015Trial
- Single relapse at ≥ 0.5 mg/kg alternate-day prednisone predicts course of childhood nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2026Observational
- Age at onset and cumulative initial prednisolone dose predict frequent relapses in steroid-sensitive nephrotic syndrome: an individual participant data systematic review and meta-analysis of placebo-controlled RCTs.Pediatric nephrology (Berlin, Germany) · 2026Review
- Article
- The 2025 KDIGO guideline on the management of nephrotic syndrome in children: a comment of the European Renal Association Immunonephrology Working Group.Clinical kidney journal · 2026Review
- Aligning Practice With Guidelines: A Canadian National Survey and Canadian Society of Nephrology Commentary on the 2025 KDIGO Pediatric Nephrotic Syndrome Recommendations.Canadian journal of kidney health and disease · 2026Article
- Steroid-sensitive nephrotic syndrome in children: Korean Society of Pediatric Nephrology clinical practice recommendations.Childhood kidney diseases · 2025Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prolonged prednisolone treatment for the initial episode of childhood nephrotic syndrome may reduce relapse rate, but whether this results from the increased duration of treatment or a higher cumulative dose remains unclear. We conducted a randomized, double-blind, placebo-controlled trial in 69 hospitals in The Netherlands. We randomly assigned 150 children (9 months to 17 years) presenting with nephrotic syndrome to either 3 months of prednisolone followed by 3 months of placebo (n=74) or 6 months of prednisolone (n=76), and median follow-up was 47 months. Both groups received equal cumulative doses of prednisolone (approximately 3360 mg/m(2)). Among the 126 children who started trial medication, relapses occurred in 48 (77%) of 62 patients who received 3 months of prednisolone and 51 (80%) of 64 patients who received 6 months of prednisolone. Frequent relapses, according to international criteria, occurred with similar frequency between groups as well (45% versus 50%). In addition, there were no statistically significant differences between groups with respect to the eventual initiation of prednisolone maintenance and/or other immunosuppressive therapy (50% versus 59%), steroid dependence, or adverse effects. In conclusion, in this trial, extending initial prednisolone treatment from 3 to 6 months without increasing cumulative dose did not benefit clinical outcome in children with nephrotic syndrome. Previous findings indicating that prolonged treatment regimens reduce relapses most likely resulted from increased cumulative dose rather than the treatment duration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.