Influence of prolonged corticosteroid therapy on the outcome of steroid-responsive nephrotic syndrome

Eighty-six patients (59 males and 27 females) diagnosed with steroid-respon sive nephrotic syndrome during childhood were identified. The patients were 20-40 years of age (mean 27.0 +/- 5.0) with a mean follow-up period of 19. 5 +/- 5.9 years. All patients had been treated with a long-term tapering co rticosteroid therapy. Thirty patients had also received a course of cycloph osphamide (2 mg/kg/day for 12 weeks). Sixty-six had achieved sustained remi ssion off corticosteroids, while 20 were still receiving corticosteroids to maintain remission. None of the 86 patients had proteinuria or renal insuf ficiency at the time of the study. Mean final heights in males and females were similar (-0.51 +/- 1.21 and -0.23 +/- 1.16 standard deviation score). Mean final height of 20 steroid-dependent patients was significantly less t han that of 66 in remission off corticosteroids (p < 0.005). Ten cyclophosp hamide-treated patients got married and 9 had at least 1 healthy child. In children with steroid-responsive nephrotic syndrome, the need for corticost eroid therapy to maintain remission may be associated with decreased adult height. Patients who received a 12-week course of cyclophosphamide are like ly to be normally fertile as adults. Copyright (C) 2001 S. Karger AG, Basel .