1. Association of initial prednisolone dose with remission, relapse, and infectious complications in adult-onset minimal change disease
- Author
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Takaaki Kosugi, Hideo Tsushima, Ken-ichi Samejima, Naoki Maruyama, Masaru Matsui, Masahiro Eriguchi, Keisuke Okamoto, Yasuhiro Akai, Kazuhiko Tsuruya, Katsuhiko Morimoto, Fumihiro Fukata, and Kaori Tanabe
- Subjects
Nephrology ,Adult ,medicine.medical_specialty ,Physiology ,Prednisolone ,PSL ,Gastroenterology ,Cohort Studies ,Recurrence ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Minimal change disease ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Proportional hazards model ,Nephrosis, Lipoid ,Correction ,medicine.disease ,Cumulative steroid doses ,Treatment Outcome ,Remission induction ,Original Article ,Renal biopsy ,business ,After treatment ,Immunosuppressive Agents ,Cohort study ,medicine.drug - Abstract
Background A dose of 0.5–1 mg/kg/day of prednisolone (PSL) is administered for the initial treatment of minimal change disease (MCD). However, little is known about the optimal PSL dose for the initial treatment of MCD. Methods We conducted a retrospective multicenter cohort study of treatment-naive adult patients with MCD diagnosed by renal biopsy from 1981 to 2015 in whom PSL monotherapy was performed as the initial treatment. The exposure of interest was an initial median PSL dose of Results Ninety-one patients met the inclusion criteria. During a median follow-up of 2.98 years, 87 (95.6%) patients achieved complete remission, and 47.1% relapsed after remission. There was no significant difference in the remission rate between the groups at 4 weeks of follow-up (66.7 vs. 82.6%). The median time to remission in Group L was comparable to that in Group H (17.0 vs. 14.0 days). A multivariable Cox hazard model revealed that the initial PSL dose was not a significant predictor of remission. The cumulative steroid doses at 6 months, 1 year, and 2 years after treatment initiation were significantly lower in Group L than in Group H. Conclusion The initial PSL dose was not associated with time to remission, remission rate, time to relapse, or relapse rate. Therefore, a low initial steroid dose may be sufficient to achieve remission.
- Published
- 2021