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Dynamic Changes in Oxidative Stress Biomarkers in a Child with Idiopathic Nephrotic Syndrome: A Longitudinal Case
Joško Osredkar1,2, Matjaž Kopač3,4
1Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Zaloška Cesta 2, 1525 Ljubljana, Slovenia.
Insights
Oxidative stress markers, including d-ROMs and PAT, dynamically reflect disease activity in pediatric idiopathic nephrotic syndrome (INS). These biomarkers show promise for monitoring treatment response and residual oxidative burden in children with INS.
Area of Science:
- Pediatric Nephrology
- Biochemistry
- Clinical Diagnostics
Background:
- Idiopathic nephrotic syndrome (INS) is a common childhood kidney disease.
- Oxidative stress is increasingly recognized as a key factor in INS pathogenesis.
- Non-invasive biomarkers are needed to track redox balance and treatment response in INS.
Abstract:
Idiopathic nephrotic syndrome (INS) is the most prevalent glomerular illness in children. Even while immunologic processes are well-established, oxidative stress is becoming more widely acknowledged as a significant factor in the etiopathogenesis of illness. Assessing its activity and treatment response may be made easier with the use of trustworthy, non-invasive indicators to track redox balance. We report on the oxidative stress levels of a 10.7-year-old boy with INS with five clinical time points in one year. The FRAS5 analyzer was used to calculate the oxidative stress index (OSI), plasma antioxidant capacity (PAT) and derivatives of reactive oxygen metabolites (d-ROMs) as biomarkers. A 4-tier oxidative state classification scheme based on d-ROM and PAT thresholds was used to interpret the values. The patient had low antioxidant defense, moderate oxidative and increased OSI at relapses, a positive transition to reduced oxidative burden and enhanced defense during remission. The order of events showed a dynamic redox response associated with glucocorticoid (GC) medication and disease activity. The potential value of d-ROM, PAT, and OSI as dynamic biomarkers for tracking disease activity, response to treatment and residual oxidative burden in pediatric INS is supported by this case. To confirm their function in more comprehensive clinical decision-making, more research is required.
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