Steroid-induced adrenal insufficiency in children with nephrotic syndrome: a systematic review

Included studies were mostly small, single-center, and methodologically heterogeneous. There was a lack of consensus on diagnostic criteria and limited long-term follow-up data. Steroid-induced AI is a common and potentially under-recognized complication in children with idiopathic NS, especially in high-risk groups. Due to inconsistent diagnostic practices, the actual prevalence of AI is unclear. There is a critical need for further research, standardized testing protocols, and clinical guidelines. Clinicians may consider screening for AI in children with high cumulative steroid exposure and consider cortisol replacement accordingly.