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Active, not recruitingNCT07071597Updated Jul 17, 2025

The Selection of Initial Treatment Regimens for Adolescent Nephrotic Syndrome.

An observational study in Nephrotic Syndrome, Adolescent and Biopsy, sponsored by Nanjing Children's Hospital. Active, not recruiting at 1 site in China. Open to participants aged 10 Years to 18 Years. Per ClinicalTrials.gov, last updated 2025-07-17.

Sponsored by Nanjing Children's Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
400
Ages
10 Years to 18 Years
Sex
All
01

Study summary

Given that the treatment strategy for adolescent PNS has a significant impact on growth and development, but there are few cases and a lack of clinical research, this study plans to collaborate with several domestic top-tier children's nephrology centers to conduct a retrospective real-world study of adolescent PNS. The aim is to understand the current diagnosis and treatment status of adolescent PNS and compare the advantages and disadvantages of various therapies, in order to provide a more scientific, rational, and effective treatment plan for adolescent PNS.

Read the detailed description

Pediatric kidney disease, especially primary nephrotic syndrome (PNS), is a common urinary system disease in pediatric clinical practice. The core pathophysiological process of nephrotic syndrome involves damage to the glomerular filtration membrane, resulting in massive proteinuria and subsequent hypoproteinemia, hyperlipidemia, and edema. PNS in children is more prevalent in the preschool age group, with minimal change disease (MCD) accounting for approximately 77.1% of pathological types. MCD is sensitive to corticosteroids, and the traditional initial treatment regimen is standard-dose corticosteroid induction therapy. In foreign countries, the pathological types of PNS in adolescents are mainly MCD and focal segmental glomerulosclerosis (FSGS). In mainland China, the proportion of mesangial proliferative glomerulonephritis (MsPGN) is increasing, but MCD remains the main pathological type. Currently, there is no consensus among guidelines from various countries on whether to perform renal biopsy and the indications for it in adolescent PNS. The Chinese pediatric PNS evidence-based guideline does not specify the age factor for renal biopsy. In the treatment protocol debate of the International Pediatric Nephrology Association (IPNA), some scholars advocate corticosteroid treatment first, while others believe that renal biopsy first can reduce steroid exposure and its side effects. However, there is still a lack of large-scale clinical data for comparison. Given that the treatment strategy for adolescent PNS has a significant impact on growth and development, but there are few cases and a lack of clinical research, this study plans to collaborate with several domestic top-tier children's nephrology centers to conduct a retrospective real-world study of adolescent PNS. The aim is to understand the current diagnosis and treatment status of adolescent PNS and compare the advantages and disadvantages of various therapies, in order to provide a more scientific, rational, and effective treatment plan for adolescent PNS.

02

Conditions studied

  • Nephrotic Syndrome
  • Adolescent
  • Biopsy

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03

Who can participate

Ages eligible
10 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Clinical data of PNS patients aged 10-18 years who met the diagnostic criteria for pediatric PNS established by the Pediatric Nephrology Group of the Chinese Medical Association in 2016, from multiple medical institutions over the past decade.

Inclusion criteria

  1. Clinical diagnosis met the criteria for PNS from January 2014 to December 2023 (①Nephrotic-range proteinuria: 24-h urine protein ≥50 mg/kg or morning urine protein/creatinine (mg/mg) ≥2.0, three consecutive morning urine protein tests (+++) to (++++) within 1 week. ②Hypoproteinemia: serum albumin \<25 g/L. ③Hyperlipidemia: serum cholesterol >5.7 mmol/L. ④Edema to varying degrees. Among the above four criteria, 1 and 2 are essential for diagnosis.);
  2. Regular follow-up for at least 1 year;
  3. Compliance with the requirements of the revised Helsinki Declaration of 2013, with informed consent obtained from patients and their families.

Exclusion criteria

Exclusion Criteria:

  1. Nephrotic syndrome secondary to other diseases;
  2. Patients requiring dialysis or after kidney transplantation;
  3. Presence of genetic defects or hereditary metabolic diseases;
  4. Concurrent with severe primary diseases such as cardiovascular, liver, brain, hematopoietic system diseases, or mental disorders;
  5. Incomplete clinical data.
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
400 participants (estimated)
Patient registry
No

Groups and cohorts

  • Treatment Group

    At the initial diagnosis, treatment is initiated with corticosteroids or immunosuppressive agents.

  • Renal Biopsy Group

    At the initial diagnosis, renal biopsy is performed first to clarify the renal pathology, and then targeted medication is used.

    Procedure: Renal Biopsy

Interventions

  • ProcedureRenal Biopsy

    Renal biopsy is performed to clarify the renal pathology.

05

What researchers measure

Primary outcomes

  1. The number of relapses of proteinuria

    The total number of proteinuria relapses in patients within 2 years of treatment is counted.

    Time frame: From the start of treatment to 1 year and 2 years.

  2. A 50% decline in kidney function

    Calculate the proportion of patients with a greater than 50% decline in kidney function at 6 months, 1 year, and 2 years of treatment.

    Time frame: At 6 months, 1 year, and 2 years of treatment.

  3. Relapse-free rate of proteinuria after treatment

    The proportion of participants who remain free of proteinuria relapse after initial treatment, assessed by urine analysis and clinical evaluation.

    Time frame: At 3 months, 6 months, 1 year, and 2 years after treatment initiation.

  4. Incidence of steroid resistance after treatment

    The proportion of participants who do not achieve remission with standard steroid therapy, assessed clinically and by laboratory evaluation.

    Time frame: At 4 weeks after treatment initiation.

06

Study locations

1 site
  • NanjingCH
    Nanjing, China
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07071597
Lead sponsor
Nanjing Children's Hospital
Responsible party
Yajing Xun (Principal Investigator, Nanjing Children's Hospital) — Principal investigator
First posted
Jul 17, 2025
Start date
Jun 1, 2025
Primary completion
Jun 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Jul 17, 2025

Study contacts

Ruochen Che
principal investigator · Nanjing Children's Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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