title: Should we stop dosing steroids per body surface area for nephrotics?
abstract: In this edition of Pediatric Nephrology, Vaishnavi Raman et al. have published an open-labeled randomized clinical trial of 100 children with idiopathic nephrotic syndrome who were allocated either a body weight- or body surface area-based prednisolone dosing for a duration of 12 weeks. The authors used Kaplan-Meier analysis for comparison of the time to remission. They also compared the relapse rate and found no difference. This editorial discusses the strengths of the current study as well some limitations. The inclusion of relapsing patients in the study protocol is problematic. The follow-up period of only 6 months forms another limitation. No subgroup analysis by age was performed. This editorial also highlights the lack of correlation between steroid dose and steroid exposure and the need for considering the age dependency (ontogeny) of drug disposition. Finally, the need for adherence to CONSORT criteria for reporting randomized controlled clinical trials is emphasized.
authors.affiliation: Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, 800 Commissioners Road East, London, ON, Canada, N6A 5 W9. guido.filler@lhsc.on.ca.|Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada, N5A 5A5. guido.filler@lhsc.on.ca.|Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada, N6A 5 W9. guido.filler@lhsc.on.ca.
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.affiliation: Department of Paediatrics, Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.|Program in Cell Biology, Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada.|Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada.|Department of Paediatrics, University of Toronto, Toronto, ON, M5S 2 J7, Canada.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Robinson
mesh_terms: D001830:Body Surface Area; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D009404:Nephrotic Syndrome / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D013256:Steroids / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D013256:Steroids; D011239:Prednisolone
keywords: Corticosteroids; Dosing; Exposure; Ontogeny of drug disposition