Evaluation of Urinary Monocyte Chemotactic Protein 1 as a Predictive Marker of Steroid Responsiveness in Children with Idiopathic Nephrotic Syndrome

Abdellatif, Ghada Mohammed; Gomaa, Mohamed Abdessalam; Khalifa, Naglaa Ali; Ahmed Metwally, Aya Ezzat; Elsharkawy, Mona Mohammed

doi:10.21608/zumj.2023.228333.2843

	Evaluation of Urinary Monocyte Chemotactic Protein 1 as a Predictive Marker of Steroid Responsiveness in Children with Idiopathic Nephrotic Syndrome
Zagazig University Medical Journal
Volume 30, Issue 1.2, January and February 2024, Page 401-409 PDF (965.75 K)
Document Type: Original Article
DOI: 10.21608/zumj.2023.228333.2843
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Authors
Ghada Mohammed Abdellatif¹; Mohamed Abdessalam Gomaa¹; Naglaa Ali Khalifa²; Aya Ezzat Ahmed Metwally ¹; Mona Mohammed Elsharkawy¹
¹Pediatrics Department, Faculty of Medicine, Zagazig University, Egypt
²Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: Nephrotic syndrome is a common pediatric kidney condition t. It happens in young children and adolescents. The goal of this research was to investigate the diagnostic value of urinary MCP-1 in pediatric patient with idiopathic nephrotic syndrome. Methods: At the pediatric nephrology outpatient clinic and the pediatric nephrology unit, this case-control study was carried out at Zagazig university hospitals on children attending at pediatric inpatient and outpatient clinic. They were divided into three groups: group A, which consisted of 27 nephrotic patients in remission; group B, which consisted of 27 nephrotic patients who were active and experiencing either their first attack or relapses; and group C, which consisted of 27 sex- and age-matched healthy children who were present at a general pediatric clinic. Results: There is a statistically significant difference in urinary monocyte chemotactic Protein 1. The best cutoff of urinary monocyte chemotactic protein 1 in diagnosis of nephrotic syndrome is ≥79 with area under curve 1, sensitivity 100%, specificity 96.3%, positive predictive value 98.2%, negative predictive value 100%, and overall accuracy 98.8%. The best cutoff steroid-resistant nephrotic syndrome by using urine monocyte chemotactic protein 1 as a diagnostic marker is ≥512 with area under curve 0.992, sensitivity 96.3%, specificity 88.9%, positive predictive value 89.7%, negative predictive value 96%, and overall accuracy 92.6%. Conclusion: The findings imply that urine MCP-1 levels can differentiate between patients with active disease and those who are in remission, as well as between cases of steroid-resistant nephrotic syndrome and cases of steroid-sensitive nephrotic syndrome.
Keywords
Idiopathic Nephrotic Syndrome; Urinary Monocyte Chemotactic Protein 1; Steroid Responsiveness


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