BMJ 1995; 310 doi: (Published 14 January 1995) Cite this as: BMJ 1995;310:116

Glomerulonephritis: diagnosis and treatment

Several paediatric nephrologists have pointed out an error in this review article by P D Mason and C D Pusey (10 December, pp 1557–63). On p 1558 Mason and Pusey state that children with minimal change nephropathy should be treated with prednisolone 1 mg/kg/day (or 2 mg/kg on alternate days) for eight to 12 weeks or for one week after induction of remission. A recent consensus statement, however, recommends prednisolone 60 mg/m2/day (maximum 80 mg/day) until remission, followed by 40 mg/m2/day (maximum 60 mg/day) on alternate days for four weeks. The prednisolone is then stopped without the dose being tapered.1 The first two relapses should be treated in a similar way. Children with frequent relapses should be given, in the first instance, maintenance treatment with prednisolone 0.1-0.5 mg/kg on alternate days for three to six months. The initial, high doses of prednisolone can be continued for four weeks; the advice of a paediatric nephrologist should be sought if remission has not occurred by then.


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