Relapses of nephrotic syndrome (NS) are commonly treated with a course of prednisolone (2 mg/kg/day or 60 mg/m2/day), which is recommended in several guidelines. Though we often experience treating relapses of NS with PSL lower than recommended dosage, the effects and prognosis of treating lower dosage PSL are unknown. We retrospectively studied 49 steroid-sensitive NS children who were treated first relapse of NS in our center between 2005 and 2016. The median dose of PSL used to relapse was 1.93 mg/kg/day and 27 (55.1%) patients were treated less than 2 mg/kg/day. All patients responded within 15 days. There was no correlation between dose of PSL and days until remission (r=0.14). Twenty-three (46.9%) patients were frequently-relapsing nephrotic syndrome (FRNS), who had more than two times relapses during 6 months after first NS remission. Among FRNS patients, age at the onset of NS, PSL dosage at first relapse, and days until remission were no significant difference compared to these parameters in non-FRNS patients. Our study found that lower dose of PSL in treating a first relapse of NS was not influence the prognosis.
"},{"@language":"ja","@value":"国内外のガイドラインでは小児期ステロイド感受性ネフローゼ症候群 (steroid sensitine nephrotic syndorome: SSNS) の再発時治療として，プレドニゾロン (prednisolone: PSL) 2 mg/kg/日または60 mg/m2/日が推奨されている。実臨床では推奨量まで増量しないことがあるが，その効果や予後への影響は不明である。そこで，当科において初発時のPSL 投与量で初回再発治療を行ったSSNS 49 名を対象に，初回再発時PSL 投与量，初回再発時の寛解までの日数，初回再発から2 回目再発までの日数，頻回再発 (frequently relapsing nephrotic syndrome: FRNS) 移行率を，診療録より後方視的に検討した。再発時のPSL 投与量は27 名 (55.1％) で2 mg/kg/日未満だったが，中央値7 日で全例寛解した。PSL 投与量と寛解までの日数，および2 回目の再発までの日数に有意な相関はなかった。初発時寛解後6 か月以内に2 回以上再発したFRNS 群23 名(46.9％)と非FRNS 群26 名の両群において，初回再発時のPSL 投与量に有意差はなかった。したがって，再発時のPSL 投与量はガイドラインの推奨量まで増量しなくても効果や予後へは影響しない可能性がある。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410282763069402241","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398968680"}],"foaf:name":[{"@language":"ja","@value":"櫻谷 浩志"},{"@language":"en","@value":"Sakuraya Koji"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Nephrology, Saitama Children’s Medical Center"},{"@language":"ja","@value":"埼玉県立小児医療センター腎臓科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282763069402242","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398968681"}],"foaf:name":[{"@language":"ja","@value":"平野 大志"},{"@language":"en","@value":"Hirano Daishi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Pediatrics, Jikei University School of Medicine Hospital"},{"@language":"ja","@value":"東京慈恵会医科大学小児科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282763069402369","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398968682"}],"foaf:name":[{"@language":"ja","@value":"西野 智彦"},{"@language":"en","@value":"Nishino Tomohiko"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Nephrology, Saitama Children’s Medical Center"},{"@language":"ja","@value":"埼玉県立小児医療センター腎臓科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282763069402368","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398968683"}],"foaf:name":[{"@language":"ja","@value":"富井 祐治"},{"@language":"en","@value":"Tomii Yuji"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Nephrology, Saitama Children’s Medical Center"},{"@language":"ja","@value":"埼玉県立小児医療センター腎臓科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282763069402240","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000398968684"}],"foaf:name":[{"@language":"ja","@value":"藤永 周一郎"},{"@language":"en","@value":"Fujinaga Shuichiro"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Nephrology, Saitama Children’s Medical Center"},{"@language":"ja","@value":"埼玉県立小児医療センター腎臓科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09152245"},{"@type":"LISSN","@value":"09152245"},{"@type":"EISSN","@value":"18813933"}],"prism:publicationName":[{"@language":"en","@value":"Japanese journal of pediatric nephrology"},{"@language":"ja","@value":"日本小児腎臓病学会雑誌"},{"@language":"en","@value":"Nihon Shoni Jinzobyo Gakkai Zasshi"},{"@language":"ja","@value":"日児腎誌"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society for Pediatric Nephrology"},{"@language":"ja","@value":"一般社団法人 日本小児腎臓病学会"}],"prism:publicationDate":"2018","prism:volume":"31","prism:number":"2","prism:startingPage":"146","prism:endingPage":"150"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"https://www.jstage.jst.go.jp/article/jjpn/31/2/31_oa.2018.0138/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2019123475"}],"availableAt":"2018","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E3%82%B9%E3%83%86%E3%83%AD%E3%82%A4%E3%83%89%E6%84%9F%E5%8F%97%E6%80%A7%E3%83%8D%E3%83%95%E3%83%AD%E3%83%BC%E3%82%BC%E7%97%87%E5%80%99%E7%BE%A4","dc:title":"ステロイド感受性ネフローゼ症候群"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%86%8D%E7%99%BA%E6%99%82PSL%20%E6%8A%95%E4%B8%8E%E9%87%8F","dc:title":"再発時PSL 投与量"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%BA%88%E5%BE%8C","dc:title":"予後"},{"@id":"https://cir.nii.ac.jp/all?q=steroid-sensitive%20nephrotic%20syndrome","dc:title":"steroid-sensitive nephrotic syndrome"},{"@id":"https://cir.nii.ac.jp/all?q=PSL%20dosage%20at%20first%20relapse","dc:title":"PSL dosage at first relapse"},{"@id":"https://cir.nii.ac.jp/all?q=prognosis","dc:title":"prognosis"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360292619345404416","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Chapter 3: Steroid-sensitive nephrotic syndrome in children"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574095174876416","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The impact of pediatric nephrotic syndrome on parents′ health-related quality of life and family functioning: An assessment made by the PedsQL 4.0 family impact module"}]},{"@id":"https://cir.nii.ac.jp/crid/1361981468473561216","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"PedsQL™ 4.0: Reliability and Validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in Healthy and Patient Populations"}]},{"@id":"https://cir.nii.ac.jp/crid/1363951793268877184","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Use of a low-dose prednisolone regimen to treat a relapse of steroid-sensitive nephrotic syndrome in children"}]},{"@id":"https://cir.nii.ac.jp/crid/2050025942144285952","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Evidence-based clinical practice guidelines for nephrotic syndrome 2014"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2005615520"},{"@type":"CROSSREF","@value":"10.3165/jjpn.oa.2018.0138"},{"@type":"CIA","@value":"130007511475"},{"@type":"OPENAIRE","@value":"doi_dedup___::5f2bc53e53bea6208d0a367e8b2914c7"}]}