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| :: Test classifies kids with kidney disease :: |
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A new urine test may help predict the response to treatment for children with the kidney disease idiopathic nephrotic syndrome (INS), according to a paper presented at the American Society of Nephrology's 38th Annual Meeting and Scientific Exposition in Philadelphia.
Led by Dr. R.P. Woroniecki of Albert Einstein College of Medicine, Bronx, N.Y., the researchers sought to develop a urine test to distinguish between children with two different types of INS: the more common, readily treatable "steroid-sensitive" form and the less common, more complex "steroid-resistant" form. Computerized "bioinformatic" techniques were used to perform detailed analyses of proteins in urine samples from 25 children with INS.
The results showed significantly different protein profiles between children with steroid-sensitive and steroid-resistant INS. Based on these differences, the test was 100 percent accurate in distinguishing between the two groups.
Idiopathic nephrotic syndrome, sometimes called "minimal change disease," is a condition of young children in which the kidneys begin losing protein into the urine. The cause of INS is unknown. As the protein level drops, patients develop problems such as swelling, decreased urination and weight gain.
Most children with INS respond to treatment with steroid drugs, but some do not. Patients with "steroid-resistant" INS need other treatments, such as immunosuppressant drugs, and are at higher risk of complications. The development of a urine test could help to simplify the evaluation of children with INS, possibly allowing earlier initiation of appropriate treatment.
The bioinformatic analysis identified a specific protein as the most important factor in distinguishing between steroid-sensitive and steroid-resistant INS. Further study of this and other proteins identified by the urine test might lead to useful new tools for diagnosis and treatment of children with INS.
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