In this report, only acute remissions of the nephrotic syndrome following triamcinolone therapy are considered. No conclusions are drawn regarding the effects of this treatment on the ultimate fate of these children. With these reservations kept clearly in mind, this experience with 15 children with the nephrotic syndrome indicates that triamcinolone is a highly effective therapeutic agent.
With the 20 mg/day dose employed for 30-45 days in this series, side-effects were absent except for the occasional appearance of slight moon facies.
The incidence of complete remission in the entire series was 10 out of 15 patients (67%). Of patients whose disease was less than 12 months in duration, and who did not have hypertension, eight out of nine patients (89%) had a complete remission. These results compare favorably with the experience reported in the literature with other steroids.
The mere induction of acute remissions, no matter how readily or reproducibly, should not be the chief concern in therapy of nephrosis. The ultimate prognosis is still pessimistic, despite regimens of therapy with currently available steroids. A recent report suggests that the long-term results of steroid therapy in the nephrotic syndrome might be improved by earlier, more intensive, and more prolonged treatment. It is the present authors impression that triamcinolone is a useful steroid for such a program, because of its high potency and minimal side-effects. The doses employed did not cause hypertension or retention of sodium.