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Pérdida de Podocitos Urinarios Asociada con la Respuesta al Tratamiento en Pacientes con Síndrome Nefrótico Primario

Bartholomeus T van den Berge^1,2, Jitske Jansen³, Quinty Leusink¹

¹Department of Nephrology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, The Netherlands.

Kidney international reports

|January 16, 2026

Resumen

La medición de la pérdida de podocitos urinarios (podocituria) puede ayudar a predecir la respuesta al tratamiento en el síndrome nefrótico primario (SNP). Los niveles elevados de podocituria en pacientes con SNP se normalizan con la remisión, lo que ayuda al pronóstico.

Área de la Ciencia:

Nefrología
Inmunología
Patología

Sus antecedentes:

El síndrome nefrótico primario (SNP) presenta un curso clínico variable, lo que dificulta la predicción temprana de la respuesta al tratamiento.
El SNP se caracteriza por lesión y posterior pérdida de podocitos, un factor clave en la progresión de la enfermedad.

Objetivo del estudio:

Investigar la asociación entre la pérdida de podocitos urinarios (podocituria) y la respuesta al tratamiento en pacientes con síndrome nefrótico primario.
Determinar si las mediciones cuantitativas de podocituria pueden servir como un marcador pronóstico para el SNP.

Principales métodos:

Inclusión de 59 pacientes con SNP (enfermedad de cambios mínimos [MCD], glomeruloesclerosis focal y segmentaria [FSGS], nefropatía membranosa [MN]) y 21 controles.
Análisis de sedimentos urinarios para marcadores específicos de podocitos utilizando citometría de flujo activada por fluorescencia (FACS) y correlación con datos clínicos.

Principales resultados:

Los pacientes con SNP exhibieron niveles significativamente más altos de podocituria en comparación con los controles.
Los niveles de podocituria se correlacionaron con la proteinuria y se normalizaron al momento de la remisión completa.
La podocituria basal diferenció a los respondedores tempranos vs. tardíos en pacientes con MCD/FSGS y se asoció con la remisión espontánea en pacientes con MN.

Conclusiones:

La podocituria elevada es un hallazgo característico en el síndrome nefrótico primario.
La evaluación cuantitativa de la podocituria tiene valor pronóstico para predecir los resultados del tratamiento en el SNP.

Palabras clave:

síndrome nefrótico primario resultado del tratamiento podocitos urinarios

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