The different lente glucocorticoid effect of remission induction on children with nephrotic syndrome

Objective To investigate the effects of different lente glucocorticoid on the primary nephrotic syndrome (PNS)children’s remission induction. Methods 54 PNS kid patients at the time of their initial treatment in Tianjin Children’s Hospital were randomly divided into three groups:prednisone group,triamcinolone group and methylprednisolone group; they were given corresponding GC treatment. Monitor 24-hour urinary protein(Upro)levels, Alb and Tcho. Record the Upro negative conversion time. Test the mRNA expression levels of the glucocorticoid receptor (GR)subtypes in PBMCs by semi-quantitative RT-PCR. Results Methylprednisolone was better than triamcinolone and prednisone on the 24 h Upro decrease and the increase of plasma Alb. Methylprednisolone and triamcinolone had a shorter Upro negative conversion time than prednisone group. The GRαup-regulation degree of methylprednisolone was better than triamcinolone and prednisone. Methylprednisolone and triamcinolone’s down-regulation ability of GRβ was superior to prednisone. Conclusion After the GC treatment,the Upro negative conversion time,changes of Upro and Alb and the level of GR can be used as valuable indicators for efficacy assessment at remission induction period. The effects of methylprednisolone or triamcinolone are better than prednisone at the remission induction period of PNS in initial treatment.