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. 2025 Aug 21;12(8):1101.
doi: 10.3390/children12081101.

Plasma Thrombospondin-1 in Etiology-Specific Associations with Proteinuria Events in Pediatric Chronic Kidney Disease

Pei-Chen Lu  1   2 , Wei-Ting Liao  1 , Chien-Ning Hsu  3   4 , You-Lin Tain  1   2   5 , Chia-An Chou  6
Affiliations

Plasma Thrombospondin-1 in Etiology-Specific Associations with Proteinuria Events in Pediatric Chronic Kidney Disease

Pei-Chen Lu et al. Children (Basel). .

Abstract

Background: Thrombospondin-1 (TSP-1) is a matricellular protein involved in kidney fibrosis, potentially influencing the progression of proteinuria. However, its potential as a predictive biomarker for proteinuria events in children with chronic kidney disease (CKD), particularly across different etiological subgroups, such as congenital anomalies of the kidney and urinary tract (CAKUT) and non-CAKUT, has not been fully explored.

Methods: In this prospective study of 60 children with CKD, we assessed baseline plasma TSP-1 and tracked proteinuria events over one year. Participants were stratified into CAKUT and non-CAKUT groups.

Results: In total, 5 of 60 participants had proteinuria events. Plasma TSP-1 was significantly lower in patients with events (21.18 vs. 36.28 μg/mL, p = 0.0364). In multivariable analysis, TSP-1 lost significance overall but remained predictive in the non-CAKUT subgroup (AUC = 0.79, p = 0.064; OR = 0.93, p = 0.028).

Conclusions: Plasma TSP-1 may serve as an etiology-specific biomarker for proteinuria events in pediatric CKD, particularly among non-CAKUT patients, and warrants further investigation for personalized risk assessment.

Keywords: biomarker; children; chronic kidney disease; proteinuria; thrombospondin-1.

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Conflict of interest statement

The authors declare no conflicts of interest, financial or otherwise, that could have influenced the outcomes of this study.

Figures

Figure 1
Figure 1
Flowchart of participant enrollment and subgroup classification.
Figure 2
Figure 2
Plasma TSP-1 and uric acid levels stratified by etiology and proteinuria events.
Figure 3
Figure 3
ROC curve of plasma TSP-1 for predicting proteinuria events in non-CAKUT pediatric CKD patients.
Figure 4
Figure 4
Fisher’s z-test reveals differences in TSP-1 correlations with clinical parameters between CAKUT and non-CAKUT groups.
Figure 5
Figure 5
Serum TSP1 and urine protein levels in patients with and without proteinuria events among nephrotic syndrome.
See this image and copyright information in PMC

References

    1. Mudalige N.L., Sun K., Plumb L., Casula A., Evans K.M., Inward C., Marks S.D. Increasing trends in hemodialysis and living donor kidney transplantation for children and young people in the United Kingdom. Pediatr. Transplant. 2022;26:e14232. doi: 10.1111/petr.14232. - DOI - PubMed
    1. Chou H.H., Lin C.Y., Chiou Y.H., Tain Y.L., Wang Y.F., Wang H.H., Chiou Y.Y. Clinical characteristics and prevalence of complications of chronic kidney disease in children: The Taiwan Pediatric Renal Collaborative study. Pediatr. Nephrol. 2016;31:1113–1120. doi: 10.1007/s00467-016-3325-5. - DOI - PubMed
    1. Bai J., Zhang L., Di J., Wang W., Wu Y., Zhou Y. Absence of progression risk of chronic kidney disease in patients with urine protein-creatinine ratio below 500 mg/g: A cohort study with competing risk analysis. Front. Med. 2025;12:1502597. doi: 10.3389/fmed.2025.1502597. - DOI - PMC - PubMed
    1. Iatridi F., Carrero J.J., Gall E.C., Kanbay M., Luyckx V., Shroff R., Ferro C.J. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease in Children and Adults: A commentary from the European Renal Best Practice (ERBP) Nephrol. Dial. Transplant. 2025;40:273–282. doi: 10.1093/ndt/gfae209. - DOI - PMC - PubMed
    1. Kishor S., Chen J., Zhang Y., Liu W., Zhu L., Xu J., Wang J. Interaction of proteinuria and diabetes on the risk of cardiovascular events: A prospective cohort CKD-ROUTE study. BMC Public Health. 2024;24:3192. doi: 10.1186/s12889-024-20715-2. - DOI - PMC - PubMed

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