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State of the Art in Pediatric Nephrology (Second Edition)
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State of the Art in Pediatric Nephrology (Second Edition)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: closed (20 March 2025) | Viewed by 2034

Special Issue Editor

Prof. Dr. Anna Maria Wasilewska

E-Mail Website
Guest Editor
Pediatric & Nephrology Department, Medical University of Bialystok, Bialystok, Poland
Interests: nephrotic syndrome; acute renal injury; hypertension
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Biomarkers play a crucial role in pediatric nephrology by aiding in diagnosing, monitoring, and managing kidney diseases in children. They play a key role in many fields, such as early diagnosis and detection of kidney dysfunction, prognosis, and risk stratification, monitoring disease progression and treatment response, differentiating disease etiologies, guiding therapeutic decisions, and predicting and monitoring complications.

Biomarkers are also crucial components in algorithms used in pediatric nephrology, as they provide valuable data points that enhance the precision and effectiveness of these algorithms. Biomarkers integrate into algorithms to improve various aspects of pediatric kidney care.

The goal of this Special Issue on the state of the art in pediatric nephrology is to highlight recent advances in algorithms in pediatric nephrology, which could be used in data integration and enhancement, improving diagnostic accuracy, personalized treatment plans, monitoring, early intervention, and research and clinical trials.

Prof. Dr. Anna Maria Wasilewska
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • algorithms
  • biomarkers
  • pediatric nephrology
  • early intervention
  • improved diagnosis

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Related Special Issue

Published Papers (4 papers)

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Research

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11 pages, 1025 KiB  
Article
Laboratory Findings and Clinical Features in IgA Vasculitis: Identifying Predictors of Kidney Involvement and Disease Relapse in Pediatric Patients
by Zofia Podraza, Karol Poplicha, Tomasz Ufniarski, Jarosław Ucieklak, Natalia Łysiak and Małgorzata Mizerska-Wasiak
J. Clin. Med. 2025, 14(9), 3055; https://doi.org/10.3390/jcm14093055 - 29 Apr 2025
Viewed by 311
Abstract
Objective: This study aimed to identify clinical and laboratory predictors of kidney involvement and disease relapse in pediatric patients with IgA vasculitis (Immunoglobulin A vasculitis, IgAV). Materials and Methods: A retrospective cohort study was conducted on 173 children diagnosed with IgAV at the [...] Read more.
Objective: This study aimed to identify clinical and laboratory predictors of kidney involvement and disease relapse in pediatric patients with IgA vasculitis (Immunoglobulin A vasculitis, IgAV). Materials and Methods: A retrospective cohort study was conducted on 173 children diagnosed with IgAV at the Children’s Clinical Hospital of the Medical University of Warsaw between 2018 and 2022. Patients were categorized into groups based on renal involvement (IgAVN+ vs. IgAVN−) and disease recurrence. The analysis included demographic data, clinical manifestations, allergy history, presence of infection, duration of hospitalization, relapse occurrence, the interval between the first and second hospitalization, and laboratory markers. Results: Renal involvement was observed in 42% of cases, while disease recurrence occurred in 9.25% of patients. IgAVN+ patients were older, had longer hospital stays, and more frequently exhibited gastrointestinal symptoms, consistent with previous research. A history of allergic conditions was more prevalent in both the IgAVN+ and recurrence groups. An increase in IgA levels over time was associated with a higher risk of nephropathic development. Patients with recurrences had higher IgM levels and an elevated neutrophil-to-lymphocyte ratio (NLR) (p = 0.07). In the ROC (Receiver Operating Characteristic) analysis, a cutoff value of 1.67 for NLR (AUC 0.71; p = 0.0002; sensitivity 0.87; specificity 0.58) was identified as a risk factor for disease recurrence. Conclusions: Older age at disease onset, gastrointestinal involvement, and allergies are associated with renal involvement in pediatric IgAV. Immune dysregulation, reflected by elevated NLR and IgM, may contribute to disease recurrence. It is important to monitor changes in IgA levels over time, as an increase in IgA concentration is a risk factor for the development of nephropathy. Additionally, calculating the NLR is recommended, as it may indicate the probability of disease recurrence. Full article
(This article belongs to the Special Issue State of the Art in Pediatric Nephrology (Second Edition))
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9 pages, 529 KiB  
Article
Urodynamic Evaluation: Is It Useful for Vesicoureteral Reflux Management?
by Joanna Bagińska-Chyży and Agata Korzeniecka-Kozerska
J. Clin. Med. 2025, 14(9), 2883; https://doi.org/10.3390/jcm14092883 - 22 Apr 2025
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Abstract
Background: Vesicoureteral reflux (VUR) is a common childhood condition where urine flows backward from the bladder to the kidney, affecting 2–5 per 1000 live births. There is still no consensus on VUR diagnostic procedures, treatment options, or the most effective timing of [...] Read more.
Background: Vesicoureteral reflux (VUR) is a common childhood condition where urine flows backward from the bladder to the kidney, affecting 2–5 per 1000 live births. There is still no consensus on VUR diagnostic procedures, treatment options, or the most effective timing of treatment. This study aimed to identify factors influencing VUR management timing, with a focus on the role of urodynamic assessment. Methods: We retrospectively analyzed 100 children with VUR, splitting them into two groups: 50 who received urodynamic assessment and 50 who did not. The median age at diagnosis for both groups was 2 years (ranging from 1 month to 14 years). The children’s medical records were analyzed to determine gender, age at VUR diagnosis and its resolution, grade, and laterality. Additionally, we recorded the clinical history of bladder dysfunction, recurrent UTIs, and renal function parameters. For those who had urodynamic assessments, we also evaluated the age at initial testing and its findings. Results: Significant differences in treatment duration were found between the study groups: 1.17 years for the group after urodynamic assessment versus 2.83 years for the group without urodynamics (p < 0.001 *). The majority of patients assessed urodynamically had an overactive bladder (52%). Conclusions: Urodynamic assessment and effective treatment of bladder dysfunction accelerate VUR resolution. Full article
(This article belongs to the Special Issue State of the Art in Pediatric Nephrology (Second Edition))
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10 pages, 993 KiB  
Article
Combined Therapy with Azathioprine, Prednisone, and Enalapril in Children with IgAN and IgAVN
by Małgorzata Mizerska-Wasiak, Miłosz Starczyński, Wojciech Wasiak, Jadwiga Małdyk, Emilia Płatos and Małgorzata Pańczyk-Tomaszewska
J. Clin. Med. 2024, 13(23), 7316; https://doi.org/10.3390/jcm13237316 - 2 Dec 2024
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Abstract
Background: The aim of this study was to evaluate the efficacy of 1-year treatment in children with IgAN and IgAVN using azathioprine, prednisone, and enalapril (AZA+PRED+E) combined with a control kidney biopsy. Methods: This study consists of 68 children diagnosed via [...] Read more.
Background: The aim of this study was to evaluate the efficacy of 1-year treatment in children with IgAN and IgAVN using azathioprine, prednisone, and enalapril (AZA+PRED+E) combined with a control kidney biopsy. Methods: This study consists of 68 children diagnosed via kidney biopsy with Oxford classification. The study group included 36 children (15 IgAN, 21 IgAVN) treated with AZA+PRED+E (according to the protocol with a control kidney biopsy); and the control group included 32 children (21 IgAN, 11 IgAVN) who were treated with enalapril alone during one year after kidney biopsy. Results: After 1 year of combined therapy, a significant reduction in both proteinuria (proteinuria = 0 in 35 patients from the study group) and hematuria in the study group was found. It was confirmed that the Δ proteinuria between the start and end of treatment in IgAN and IgAVN patients from the study group was significantly higher than the Δ proteinuria between the start and end of treatment in the control IgAN and IgAVN group treated with enalapril (30.7 ± 43.6 vs. 8.7 ± 8.7; p = 0.015; 68.2 ± 58.3 vs. 19.3 ± 20.3; p = 0.008 respectively). In the Oxford classification a high frequency of improvement in E and T in the study group after treatment was observed. Conclusions: Patients with higher proteinuria and a higher MESTC score require consideration of the strategy of immunosuppressive treatment so that therapy with AZA+PRED+E may be used as a personal treatment plan for children with these diseases. Full article
(This article belongs to the Special Issue State of the Art in Pediatric Nephrology (Second Edition))
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Review

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13 pages, 1422 KiB  
Review
Modern Biomarkers in IgA Nephropathy and Their Potential in Paediatric Research
by Agnieszka Such-Gruchot, Małgorzata Mizerska-Wasiak, Emilia Płatos and Małgorzata Pańczyk-Tomaszewska
J. Clin. Med. 2025, 14(9), 3263; https://doi.org/10.3390/jcm14093263 - 7 May 2025
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Abstract
Immunoglobulin A nephropathy (IgAN) is one of the most common forms of glomerulonephritis and one of the main causes of end-stage renal disease (ESRD), affecting up to 40% of patients after 20 years of the disease. Over the past few years, several studies [...] Read more.
Immunoglobulin A nephropathy (IgAN) is one of the most common forms of glomerulonephritis and one of the main causes of end-stage renal disease (ESRD), affecting up to 40% of patients after 20 years of the disease. Over the past few years, several studies have been conducted to search for biomarkers that can diagnose IgAN in a non-invasive way, select patients in the asymptomatic phase, assess the progression of the disease process and monitor its efficacy, and assess the risk of IgA nephropathy progression. Non-invasive investigations using molecules as an alternative to renal biopsy have potential relevance for diagnosis, the determination of treatment efficacy and the assessment of disease activity. For the early screening of IgAN with isolated haematuria, these factors may be useful for early intervention and result in a reduction in the risk of impaired renal function. The clinical studies discussed in this review underline that featured molecules show potential as biomarkers for the diagnosis and assessment of disease progress in IgAN. Full article
(This article belongs to the Special Issue State of the Art in Pediatric Nephrology (Second Edition))
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