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Background <p>Persistent urinary loss of iron-handling proteins such as transferrin in pediatric steroid-resistant nephrotic syndrome (SRNS) can lead to anemia. This study evaluated and compared iron deficiency, iron deficiency anemia and urinary transferrin levels in SRNS with steroid-sensitive nephrotic syndrome (SSNS).</p> Methods <p>100 children (50 SRNS, 50 SSNS) under 12 years were enrolled at a tertiary care center in Northern India between July and December 2022. Hematologic and iron metabolism parameters, including urinary transferrin, were analyzed in SRNS and SSNS groups to compare anemia prevalence and identify contributing factors.</p> Results <p>Hemoglobin levels were significantly lower in SRNS [10.95&#xa0;g/dl (9.77, 12.83)] than in SSNS [12.45&#xa0;g/dl (11.33, 13.4)] with OR 1.4 (1.1, 1.78). However, serum ferritin [SRNS 18.1 ng/ml (6.9, 52.85) and SSNS 14ng/ml (2.42, 24.6); 0.99 (0.98, 1)], transferrin saturation [20% (14.79, 34.98) in SRNS and 19.47% (11.1, 21.49) SSNS; OR 0.98 (0.96, 1.01)] and urinary transferrin [median in SRNS 5.79&#xa0;mg/dl (2.28, 54.1) and in SSNS group − 2.28&#xa0;mg/dl (2.28, 7.27); OR 0.99 (0.98, 1)] showed no significant intergroup variation. ROC analysis for urinary transferrin to detect anemia yielded an AUC of 0.56. The optimal cutoff (2.67&#xa0;mg/dl) had a sensitivity of 51.3% and specificity of 62.3%.</p> Conclusion <p>Children with SRNS are at increased risk of anemia. However, iron deficiency was comparable to SSNS. Urine transferrin loss can contribute to anemia but is a weak biomarker for detection of anemia.</p>

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Iron deficiency and urine transferrin levels in pediatric steroid-resistant versus steroid- sensitive nephrotic syndrome: a cross-sectional comparative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月19日

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  • Ihina Tinna,
  • Pujitha Vallabhaneni,
  • Lesa Dawman,
  • Prateek Bhatia,
  • Amit Rawat,
  • Karalanglin Tiewsoh

摘要

Background

Persistent urinary loss of iron-handling proteins such as transferrin in pediatric steroid-resistant nephrotic syndrome (SRNS) can lead to anemia. This study evaluated and compared iron deficiency, iron deficiency anemia and urinary transferrin levels in SRNS with steroid-sensitive nephrotic syndrome (SSNS).

Methods

100 children (50 SRNS, 50 SSNS) under 12 years were enrolled at a tertiary care center in Northern India between July and December 2022. Hematologic and iron metabolism parameters, including urinary transferrin, were analyzed in SRNS and SSNS groups to compare anemia prevalence and identify contributing factors.

Results

Hemoglobin levels were significantly lower in SRNS [10.95 g/dl (9.77, 12.83)] than in SSNS [12.45 g/dl (11.33, 13.4)] with OR 1.4 (1.1, 1.78). However, serum ferritin [SRNS 18.1 ng/ml (6.9, 52.85) and SSNS 14ng/ml (2.42, 24.6); 0.99 (0.98, 1)], transferrin saturation [20% (14.79, 34.98) in SRNS and 19.47% (11.1, 21.49) SSNS; OR 0.98 (0.96, 1.01)] and urinary transferrin [median in SRNS 5.79 mg/dl (2.28, 54.1) and in SSNS group − 2.28 mg/dl (2.28, 7.27); OR 0.99 (0.98, 1)] showed no significant intergroup variation. ROC analysis for urinary transferrin to detect anemia yielded an AUC of 0.56. The optimal cutoff (2.67 mg/dl) had a sensitivity of 51.3% and specificity of 62.3%.

Conclusion

Children with SRNS are at increased risk of anemia. However, iron deficiency was comparable to SSNS. Urine transferrin loss can contribute to anemia but is a weak biomarker for detection of anemia.