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Cortisol is an important hormone which produced by adrenocortical cell as respond to ACTH from pituitary gland. This hormone has important role in controlling carbohydrate, protein, and lipid metabolism, maintaining blood pressure, decreasing capillary permeability and nitric oxide, and also preventing hypotension in stress condition. Nephrotic syndrome is glomerular disease which indicated by heavy protein urine (≥ 40 mg/m²/hour or more than 50 mg/kg/day or dipstick ≥ 2+), hypoalbuminemia (≤ 2.5 g/dL), oedema, and may accompanied by hypercholesterolemia (> 200 mg/dL). According to KDIGO and IDAI, the protocol therapy for sensitive steroid nephrotic syndrome is prednisone which is divided into 2 phases (initial prednisone 60 mg/m² for 3 – 4 weeks in divided dose or single dose followed by the alternate day 40 mg/m² for 4 – 12 weeks). The different administration of prednisone (singe or divided) may cause different pattern in cortisol level. So it was important to assess cortisol level in children with high dose and long term prednisone exposure based on its protocol. This article will discuss about the potential development of adrenal suppression which indicated by cortisol level in patient who took prednisone in single or divided dose by monitoring cortisol level.