Procalcitonin and minimal-change nephropathy: a pilot study

Area of Science:

• Pediatric Nephrology
• Clinical Immunology

Background:

• Minimal-change nephropathy (MCN) is a common cause of nephrotic syndrome in children.
• Differentiating MCN relapses from infections with proteinuria flares is clinically challenging.
• Procalcitonin (PCT) is a biomarker investigated for its role in infection and inflammation.

Purpose of the Study:

• To assess the utility of procalcitonin (PCT) in distinguishing minimal-change nephropathy (MCN) relapses from concurrent infections in pediatric patients.
• To compare the diagnostic performance of PCT with C-reactive protein (CRP) in these clinical scenarios.

Main Methods:

• Retrospective and prospective data collection of PCT levels in children with MCN at different stages: relapse, proteinuria with infection, and remission.
• Comparison with healthy children experiencing infections and controls.
• Analysis of PCT and CRP diagnostic accuracy (sensitivity x specificity).

Main Results:

• Significant differences in PCT levels were observed between MCN relapse/infection groups and remission/control groups.
• PCT demonstrated higher diagnostic predictability than CRP in MCN relapses.
• PCT showed comparable performance to CRP in differentiating infection-related proteinuria.

Conclusions:

• A combined approach using PCT and CRP may improve the discrimination between infection-induced proteinuria and sole MCN relapses.
• PCT may reflect the broader immune dysregulation associated with MCN.