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The Impact of Microelements in the Individualized Approach to Pediatric Nephrotic Syndrome
Elena Jechel1, Iuliana Magdalena Starcea1, Ancuta Lupu1
1Pediatrics, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi 700115, Romania.
Abstract:
Nephrotic syndrome (NS) is a widely studied condition in current research owing to its chronic nature, diverse characteristics, and unique morbidity and mortality patterns. These factors have increased the focus on developing adjunctive and personalized treatment strategies. In line with international guidelines, we performed a review of the scientific literature to explore the role of trace elements in the pathophysiology of pediatric NS. Our primary focus was on strategies for predicting and intervening in the natural progression of the disease. To achieve these goals, we conducted a comprehensive search of the major international databases covering the period from 2000 to 2024. Additionally, we reviewed the bibliographies of the selected publications for previously published key references in the field. The main findings were presented as a narrative, emphasizing the relationship between trace element levels in serum and urine and the progression of pediatric NS, including relapse frequency, infection risk, progression to chronic kidney disease, hospitalization needs, and related complications. A concise overview of the relevant trace elements was also provided. The gathered data overwhelmingly support the connection between trace element deficiency or supplementation and the variability in NS patterns. The practical aim of this article is to raise awareness about the effectiveness and benefits of trace element supplementation in pediatric patients with NS. Moreover, we are confident that the application of this increased understanding of the influence of microelement dynamics on the pathophysiological and therapeutic characteristics will lead to reduced disease-related morbidity children with NS.
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