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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2025; 14(4): 110374
Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.110374
Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.110374
Impact of glucocorticoid therapy on hypothalamic-pituitary-adrenal axis function in pediatric nephrotic syndrome: A narrative review
Subhankar Sarkar, Department of Pediatrics, All India Institute of Medical Sciences, Kalyani, Kolkata 700019, West Bengal, India
Asiri Samantha Abeyagunawardena, Department of Pediatrics, University of Peradeniya, Peradeniya, 20400, Sri Lanka
Rajiv Sinha, Division of Paediatric Nephrology, Institute of Child Health, Kolkata, Kolkata 700017, India
Author contributions: Sarkar S performed the literature review, analyzed the data, and prepared the initial draft of the manuscript; Abeyagunawardena AS contributed to the interpretation of findings and provided critical revisions; Sinha R conceptualized the review, provided supervision, and finalized the manuscript; all authors reviewed and approved the final version.
Conflict-of-interest statement: We declare that there is no conflict of interest regarding the publication of this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rajiv Sinha, Division of Paediatric Nephrology, Institute of Child Health, Kolkata, Biresh Guha Street, Kolkata 700017, India. rajivsinha_in@yahoo.com
Received: June 6, 2025
Revised: June 29, 2025
Accepted: September 18, 2025
Published online: December 9, 2025
Processing time: 147 Days and 21.6 Hours
Revised: June 29, 2025
Accepted: September 18, 2025
Published online: December 9, 2025
Processing time: 147 Days and 21.6 Hours
Core Tip
Core Tip: Children with nephrotic syndrome often require repeated glucocorticoid therapy, which can lead to hypothalamic-pituitary-adrenal axis suppression and secondary adrenal insufficiency. This impaired stress response may contribute to relapse during infections. This review summarizes the mechanisms, diagnostic methods, clinical implications, and preventive strategies, underscoring the need for early identification and tailored steroid management to reduce long-term risks.