Toward personalized medicine in childhood nephrotic syndrome

Childhood idiopathic nephrotic syndrome remains treated empirically despite profound pathophysiological heterogeneity. Tu et al. develop a polygenic risk score incorporating clinical data and human leukocyte antigen class II variants to stratify steroid responsiveness at diagnosis. Although predictive performance remains modest and several limitations preclude immediate clinical translation, this work represents a pivotal step toward precision nephrology, envisioning a future where clinical, serologic, and genetic markers converge to guide personalized therapy, minimize steroid exposure, and improve long-term outcomes for children with nephrotic syndrome.