The first randomized controlled trial in pediatric nephrology: the history of the International Study of Kidney Disease in Children (ISKDC)

Pediatr Nephrol. 2023 Dec;38(12):3947-3954. doi: 10.1007/s00467-022-05838-1. Epub 2023 Jan 10.

Abstract

The International Study of Kidney Disease in Children (ISKDC), begun in 1966, conducted the first international collaborative randomized blinded controlled trial in pediatric nephrology and one of the first in either pediatrics or nephrology. For this trial, the ISKDC developed the criteria, such as those for response and relapse, used today to describe the clinical course of the nephrotic syndrome, and the trial generated the nephropathologic terminology and criteria which largely remain the current standards. Over an approximately 20-year span, the ISKDC followed the natural history and evaluated the therapeutic effectiveness of therapies in over 500 children with the nephrotic syndrome from three continents. It published 14 peer-reviewed studies and several reports and commentaries, many of which helped create current standards of practice for therapy of childhood nephrotic syndrome and consequently remain highly cited today. The ISKDC continues to be an important model for subsequent collaborative studies and was the impetus for the development of regional and national pediatric nephrology societies leading to the recognition and growth of pediatric nephrology as a separate subspecialty. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: ACTH; Azathioprine; Cyclophosphamide; ISKDC; Minimal change disease; Nephrotic syndrome; Randomized controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Child
  • Drug Administration Schedule
  • Humans
  • Kidney Diseases* / drug therapy
  • Kidney Diseases* / therapy
  • Nephrology*
  • Nephrotic Syndrome* / drug therapy
  • Nephrotic Syndrome* / therapy
  • Recurrence