{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:10:01Z","timestamp":1790266201534,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Corticosteroids remain the cornerstone of therapy for steroid-sensitive nephrotic syndrome (SSNS), yet the optimal dosing strategy, single daily versus divided doses, remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review of studies comparing once-daily and divided-dose prednisolone in children with SSNS. Three randomized controlled trials and one non-randomized study were included, enrolling a total of 288 patients. Primary outcomes were time to remission and relapse frequency; secondary outcomes included hypothalamic\u2013pituitary\u2013adrenal (HPA) axis suppression and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, remission rates were comparable between single and divided dosing. In relapse settings, one trial showed faster remission with split dosing (by 1\u20132\u00a0days), though without differences in relapse frequency or safety. In first-episode disease, single daily dosing was associated with less HPA axis suppression and a longer time to first relapse. Adverse event profiles were similar across regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Single-dose and split-dose prednisolone regimens\u00a0demonstrate\u00a0comparable remission efficacy in children with SSNS. Divided dosing may shorten remission by 1\u20132\u00a0days during relapse episodes, but this small benefit must be weighed against the greater HPA-axis suppression\u00a0observed\u00a0with multi-dose schedules. Given the heterogeneity and small sample sizes of available trials, the current evidence\u00a0remains\u00a0insufficient to\u00a0establish\u00a0superiority. Larger multicenter RCTs with standardized protocols and longer follow-up are needed to\u00a0provide\u00a0more definitive guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p>A higher resolution version of the Graphical abstract is available as Supplementary information<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-026-07175-z","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T06:28:41Z","timestamp":1772260121000},"page":"3841-3851","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-dose versus multi-dose steroid therapy in pediatric nephrotic syndrome: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7858-7724","authenticated-orcid":false,"given":"Candela","family":"Romano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0010-8366","authenticated-orcid":false,"given":"Lisyareli Salazar","family":"Arriaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4091-9595","authenticated-orcid":false,"given":"Linda Estefania Cordero","family":"Velez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3898-7189","authenticated-orcid":false,"given":"Alexandra Melendez","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5463-5402","authenticated-orcid":false,"given":"Tatiana Alexandra Moreno","family":"D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9247-5610","authenticated-orcid":false,"given":"Haya","family":"Al Shakkakee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8103-6175","authenticated-orcid":false,"given":"Abhigna Reddy","family":"Kudumula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8975-6335","authenticated-orcid":false,"given":"Steysi Connie Falcon","family":"Aragon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2237-9536","authenticated-orcid":false,"given":"Ernesto Calderon","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"7175_CR1","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1016\/S0140-6736(23)01051-6","volume":"402","author":"M Vivarelli","year":"2023","unstructured":"Vivarelli M, Gibson K, Sinha A, Boyer O (2023) Childhood nephrotic syndrome. 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