Table 3.

Summary of selected recommendations of treatment of first bout and relapse of idiopathic nephrotic syndrome in children

Recommendations	First bout	Relapse
International Study of Kidney Disease in Children 1978 [9]	Prednisone 60 mg/m2/24 h for 4 weeks, followed by 40 mg/m2/48 h for 4 weeks	Prednisone 60 mg/m2/24 h until negative urine, followed by a single dose of 40 mg/m2/48 h
KDIGO Clinical Practice Guideline for Glomerulonephritis 2012 [2]	Prednisone 60 mg/m2/24 h or 2 mg/kg/24 h (max. 60 mg) in a single dose for 4-6 weeks, followed by a single dose of 40 mg/m2/48 h or 1.5 mg/kg/24 h (max. 40 mg) for 4-6 weeks. Thereafter prednisone dose is gradually tapered. Total duration of therapy – 12-24 weeks	Prednisone 60 mg/m2/24 h or 2 mg/kg/24 h (max. 60 mg) in a single dose until negative urine for 3 days, followed by a single dose of 40 mg/m2/ 48 h or 1.5 mg/kg/48 h (max. 40 mg) for at least 4 weeks
Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of nephrotic syndrome in children 2014 [26]	Prednisone 60 mg/m2/24 h or 2 mg/kg/24 h (max. 60 mg) in a single dose for 4-6 weeks, followed by a single dose of 40 mg/m2/48 h or 1.5 mg/kg/24 h (max. 40 mg) for 4-6 weeks. Thereafter prednisone dose is gradually tapered. Total duration of therapy – 12-24 weeks. Most patients should be treated for 12 weeks	Prednisone 60 mg/m2/24 h or 2 mg/kg/24 h (max. 60 mg) in a single dose until negative urine for 3 days, followed by a single dose of 40 mg/m2/ 48 h or 1.5 mg/kg/48 h (max. 40 mg) for at least 4 weeks
Recommendations of Polish Society for Paediatric Nephrology 2015 [12]	Prednisone 60 mg/m2/24 h or 2 mg/kg/24 h (max. 60 mg) in a single dose for 4-6 weeks, followed by a single dose of 40 mg/m2/48 h or 1.5 mg/kg/24 h (max. 40 mg) for 4-6 weeks. Thereafter prednisone dose is gradually tapered. Total duration of therapy – 24 weeks	Prednisone 60 mg/m2/24 h or 2 mg/kg/24 h (max. 60 mg) in a single dose until negative urine for 3 days, followed by a single dose of 40 mg/m2/48 h or 1.5 mg/kg/48 h (max. 40 mg) for 4 weeks. Thereafter prednisone dose is gradually tapered during 4 weeks
Recommendations of the Italian Society for Pediatric Nephrology 2017 [7]	Prednisone 60 mg/m2/24 h (max. 60 mg) in a single dose or divided into 2 doses for 6 weeks, followed by a single dose of 40 mg/m2/48 h (max. 40 mg) for 6 weeks. Total duration of therapy – 12 weeks	Prednisone 60 mg/m2/24 h (max. 60 mg) in a single dose or divided into 2 doses until negative urine for 5 days, followed by a single dose of 40 mg/m2/48 h (max. 40 mg) for 4 weeks
Current British practice (according to PREDNOS protocol) 2019 [6]	Prednisolone 60 mg/m2/24 h (max. 60 mg) for 4 weeks, followed by 40 mg/m2/48 h (max. 40 mg) for 4 weeks	Prednisone 60 mg/m2/24 h (max. 60 mg) until negative urine for 3 days, followed by 40 mg/m2/ 48 h (max. 40 mg) for 1 week, then taper by 10 mg/m2/day per week to complete a total of 4 weeks
Management of idiopathic childhood nephrotic syndrome in Sub-Saharan Africa: Ibadan consensus statement 2021 [8]	Prednisone 60 mg/m2/24 h (max. 60 mg) in a single dose for 6 weeks, followed by a single dose of 40 mg/m2/48 h (max. 40 mg) for 6 weeks. Thereafter prednisone dose is tapered at the rate of 10 mg/m2/week to 5 mg on alternate days. The dose of prednisone should be discontinued once tapered down to 5 mg on alternate days. Total duration of therapy – 16 weeks	Prednisone 60 mg/m2/24 h (max. 60 mg) in a single dose or divided into 2 doses until negative urine for 3 days, followed by a single dose of 40 mg/m2/48 h (max. 40 mg) for 1 week, then taper by 10 mg/m2/day per week to complete a total of 4 weeks

KDIGO – Kidney Disease: Improving Global Outcomes, PREDNOS – PREDnisolone in NephrOtic Syndrome