Abstract: FR-PO0947
Implementing Guidelines for Successful Steroid Dose Decrease in Pediatric Patients with Lupus Nephritis: A Single-Center Report
Session Information
- Pediatric Nephrology: Genetic Diseases, Development, Neonatal Nephrology, Glomerular Diseases, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Cody, Ellen, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Simon, Nathan J., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Nocton, James J., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Background
Lupus nephritis (LN) occurs frequently in children with systemic lupus erythematosus (SLE) and contributes significantly to morbidity and mortality. Remission rates with current treatments remain suboptimal, which can lead to adverse effects and morbidity. Of particular importance is the morbidity associated with glucocorticoids, particularly in the pediatric population.
Methods
This was a single center retrospective study. We compared the duration of steroids used in patients pre and post roll-out of steroid guidelines developed by rheumatology and nephrology. Secondary outcomes included measures of Lupus Nephritis activity such as urine protein to creatinine ratio, renal function, and use of other agents.
Results
11 patients were included in the study, 7 patients post roll-out of the guidelines and 4 pre roll output. The main therapies used remained MMF for both groups. Figure 1 demonstrates average time to steroid discontinuation, with improvement after the introduction of the guideline, from 700 days, to under 300 days. Figure 2 demonstrates that there was no difference in UPC and renal function between the two groups despite the difference in steroid use.
Conclusion
In this small, single center study, we successfully demonstrated reduction in steroid use in patients with the use of therapeutic guidelines. It is noted that even in the post-guideline group, they remained on steroids longer than goal (6 months).