Initial Prednisolone Weaning in Nephrotic Syndrome: adrenal suppression and its association with relapse

Initial treatment for Idiopathic childhood nephrotic syndrome is prednisolone. In Victoria our routine duration of prednisolone treatment has been 12 weeks, with a multi-step tapering dose used after 4 weeks of treatment. An alternative regime is used elsewhere in Australia, which has a two-step wean over 8 weeks. Prednisolone courses can rarely be complicated by a side effect called adrenal suppression, which is where natural adrenal gland steroid production is reduced. The Initial Prednisolone Weaning and Adrenal Suppression in Childhood Nephrotic Syndrome study is a clinical trial that will compare the two different courses of prednisolone, the multi-step wean over 12 weeks and the two-step wean over 8 weeks, in patients with their first presentation of idiopathic childhood nephrotic syndrome. The study will find out how frequently adrenal suppression occurs after different courses of prednisolone, and whether there is any association with nephrotic relapse.