PHARMACOLOGICAL STRATEGIES FOR MAINTAINING REMISSION AND REDUCING RELAPSES IN PEDIATRIC IDIOPATHIC NEPHROTIC SYNDROME: AN INTEGRATIVE REVIEW

Abstract

This study aimed to analyze the pharmacological strategies used to maintain remission and reduce relapses in pediatric patients with idiopathic nephrotic syndrome. An integrative literature review was conducted in September 2026 using the PubMed and Virtual Health Library (VHL) databases, with the descriptors “Nephrotic Syndrome”, “Recurrence”, and “Child”, combined using the Boolean operator AND. Filters were applied for publications from the previous five years, free full-text availability, and controlled clinical trials or observational studies. Of the 1,865 records initially identified, 12 studies met the eligibility criteria after duplicate removal. The studies investigated different corticosteroid regimens, rituximab and other anti-CD20 antibodies, as well as maintenance strategies using mycophenolate mofetil. Prolonging or intensifying corticosteroid therapy did not consistently prevent relapses. Rituximab showed favorable outcomes, particularly in patients with frequently relapsing or steroid-dependent disease, while maintenance therapy with mycophenolate mofetil showed potential to prolong remission. It was concluded that therapeutic decisions should consider the patient’s clinical profile and disease course, and that further studies are needed to establish more effective and safer treatment regimens.