The pathogenesis of nephrotic syndrome in childhood is still not clear. In most cases minimal change disease, diffuse mesangial proliferation or focal and segmental glomerulosclerosis (FSGS) cause the nephrotic syndrome. To date many studies have revealed that podocytes are the major players in the pathogenesis. The loss of podocytes in urine resulting in podocytopenia is involved in the development of the FSGS.
The aim of the study: We introduced the method of detection of the podocytes in urine and evaluated the podocytes in urine and their association with the clinical course of the idiopathic nephritic syndrome in childhood. We also preliminary estimated this method as a diagnostic tool.
Material and methods: The study group consisted of 50 children with nephrotic syndrome. The podocytes in urine were identified by antibodies against podocalyxin with immunofluorescence method. Statistical analysis looking for correlations between clinical characteristic of nephrotic syndrome and podocyturia was done.
Results: Podocyturia was detected in 6 patients. No correlation between clinical characteristic of nephrotic syndrome and podocyturia was found.
Conclusions: Podocyturia is not a constant sign. Podocyturia does not correlate exclusively with FSGS and is present in different histopathological types of glomerulonephritis. Podocyturia does not correlate with proteinuria and clinical characteristics of nephrotic syndrome. Evaluation of the podocyte presence in urine may be a valuable fulfillment of the standard diagnostic methods in glomerulopathies, but its role in the differential diagnosis of glomerulopathies needs further studies.