Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Biomarkers Predicting Treatment-Response in Nephrotic Syndrome of Children: A Systematic Review

  • Lee, Jiwon M. (Division of Rare Disease Management, Bureau of Chronic Disease Management, Korea Disease Control and Prevention Agency) ;
  • Ahn, Yo Han (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lim, Seon Hee (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kang, Hee Gyung (Department of Pediatrics, Seoul National University College of Medicine)
  • Received : 2021.04.06
  • Accepted : 2021.06.24
  • Published : 2021.12.31
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Abstract

Purpose: Nephrotic syndrome (NS) is the most common form of glomerulopathy in children. Most pediatric patients respond to glucocorticosteroid treatment (steroid-sensitive NS, SSNS), while approximately 10-15% will remain unresponsive or later become steroid-resistant. There has been a long-standing effort to find biomarkers that may predict steroid responsiveness. Methods: We systematically reviewed current studies which investigated clinically relevant biomarkers for predicting steroid responsiveness in pediatric NS. We performed a PubMed and EMBASE search to identify eligible articles. We collected data on urinary markers, blood/serum markers (including cellular phenotypes and mRNA expression), genotypes and HLA allele frequency. Results: A total of 659 articles were identified following electronic and manual searches. After reviewing the titles, abstracts, and full texts, 72 eligible articles were finally included. Vitamin D-binding protein (VDBP) seemed to be significantly elevated in SRNS than in SSNS, in both serum and urine specimen, although further validation is required. Conclusions: The present paper narratively illustrates current understandings of potential biomarkers that may help predict steroid responsiveness. Further investigation and collaboration involving a larger number of patients are necessary.

Keywords

Acknowledgement

This research was supported by research resettlement fund for the new faculty of Seoul National University.

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