Kids Kidney Research

Idiopathic nephrotic syndrome is the commonest glomerular disorder of childhood with an incidence of 2-4 cases per 100,000 children in the UK. Around 80% of cases are due to minimal change disease and the majority will respond to corticosteroid therapy.

The ideal initial corticosteroid regimen at presentation of childhood nephrotic syndrome should rapidly induce urinary remission with resolution of oedema (retained fluid); it must be sufficient to prevent frequent relapses necessitating the use of second-line agents, though not so intensive that serious side-effects develop.

There is little national or international consensus regarding the best way to treat children with nephrotic syndrome at disease presentation. An appropriately designed and powered trial that will allow a definite statement to be made regarding the ideal course of corticosteroid therapy in British children is required.

This project will carry out a pilot study for such a trial. Specifically, a long-term (four months) tapering prednisolone regimen will be compared with the standard two months regimen as originally proposed by the International Study of Kidney Disease in Children (ISKDC). The information from this study will enable the fine-tuning of the definitive study’s design and will provide evidence of successful collaboration, thus enhancing the prospects for obtaining funding for a definitive trial.