REduced-dose Steroid PrOtocol for Childhood Nephrotic SyndromE (RESPONSE)

Inclusion criteria

• ✓. Provide informed consent ± assent
• ✓. Participant age 1-18 years
• ✓. Diagnosis of idiopathic nephrotic syndrome (defined as nephrotic-range proteinuria \[first morning or 24-hour urine protein/creatinine ratio ≥200mg/mmol or ≥3+ protein on dipstick\] and either hypoalbuminemia \[serum albumin \<30g/L\] or edema)
• ✓. Active nephrotic syndrome relapse at time of enrolment (defined as recurrence of nephrotic-range proteinuria \[≥3+ protein on dipstick for ≥3 consecutive days18 OR first morning or 24-hour urine protein/creatinine ratio ≥200mg/mmol AND ≥1+ protein on dipstick for ≥3 consecutive days\])
• ✓. Ability to take oral medication and willingness to adhere to either study prednisone regimen
• ✓. Ability and willingness to adhere to home urine and symptom monitoring during the initial two-week period after assigned treatment initiation
• ✓. Have not been previously included in the RESPONSE trial
• ✓. Participant located in Ontario, Canada at the time of study enrolment

Exclusion criteria