Time for initial response to steroids is a major prognostic factor in idiopathic nephrotic syndrome

J Pediatr. 2010 Jun;156(6):965-971. doi: 10.1016/j.jpeds.2009.12.020. Epub 2010 Mar 10.


Objective: To identify early prognostic factors for idiopathic nephrotic syndrome (INS) in childhood.

Study design: A retrospective analysis of 103 patients with INS at onset, all treated in a single center with the same induction protocol, was conducted. Minimum length of follow-up was 2 years; median length of follow-up was 43 months. Survival data were assessed with Cox-Mantel analysis. Predictive values were estimated with receiver operating characteristic curves.

Results: The median time of response to steroid therapy was 7 days. A significant association was found between the interval from onset of steroid therapy to remission and the risk of relapsing within 3 months after steroid therapy discontinuation (P < .0001). A similar association was found between the time to achieve remission and the risk of developing frequent relapsing or steroid-dependent nephrotic syndrome (P < .0001), the prescription of maintenance steroid therapy (P < .003), and the prescription of all other non-steroid drugs (P < .0001) during follow-up. Patients with non-relapsing and infrequent relapsing nephrotic syndrome had a median time to achieve remission <7 days; in patients with frequent relapsing and steroid-dependent nephrotic syndrome, this median was >7 days.

Conclusion: The interval from onset of steroid therapy to remission is an accurate early prognostic factor in INS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cyclosporine / therapeutic use
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Nephrotic Syndrome / drug therapy*
  • Prednisone / therapeutic use*
  • Prognosis
  • ROC Curve
  • Remission Induction
  • Retrospective Studies
  • Sensitivity and Specificity


  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclosporine
  • Prednisone