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MCD Steroid Taper — ESENeph MCQ

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ModerateGlomerulonephritisMCD Steroid TaperESENeph

A 45-year-old woman with biopsy-proven minimal change disease on high-dose Prednisolone develops Cushingoid features after 6 weeks but achieves complete remission. She is concerned about steroid side effects. What is the recommended steroid taper approach?

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Correct answer: A — Taper over 6 months – rapid taper increases relapse risk; total initial course plus taper typically spans 4-6 months in adults

In adult MCD, KDIGO 2021 recommends that after achieving remission on high-dose steroids, the dose should be tapered gradually over several months (typically reducing by 5 mg every 1-2 weeks once at a lower dose). Rapid steroid withdrawal increases relapse risk. The total course of initial high-dose plus taper typically spans 4-6 months in adults. If relapse occurs during taper, the dose is increased back to the last effective level before resuming taper more slowly.

Reference: KDIGO 2021 – Glomerular Disease Guideline