EARLY DETECTION OF RENAL TUBULAR DISORDERS USING BIOCHEMICAL MARKERS IN CHILDREN BELOW AGE OF 12 YEARS IN SOUTHERN PUNJAB
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Keywords
Renal Tubular Disorders, Biochemical Markers, Children <12
Abstract
Objective: To assess the diagnostic potential of serum tissue cystatin-associated factor (t-CAF) and a panel of urinary biomarkers netrin-1, α-glutathione S-transferase (α-GST), π-glutathione S-transferase (π-GST), calbindin-D28K, and calprotectin (S100A8/A9) in the early identification of renal tubular disorders among pediatric populations under 12 years of age in Southern Punjab.
Materials and methods: This cross-sectional study enrolled 120 children under age 12 years exhibiting clinical indications of renal tubular dysfunction and 31 sex-matched healthy controls. All participants were normoalbuminuric and excluded for known metabolic or glomerular diseases. The patient cohort was further categorized into two subgroups based on clinical severity indices. Serum t-CAF and urinary biomarker levels were measured using validated enzyme-linked immunosorbent assay (ELISA) kits under standardized laboratory conditions. Comparative statistical analyses were performed to evaluate the association of these markers with early tubular injury. Data analysis was done using SPSS 23 with p-value <0.05 considered as significant.
Results: Serum t-CAF levels were significantly elevated in children with suspected tubular dysfunction compared to healthy controls (p < 0.05). Similarly, urinary concentrations of netrin-1, α-GST, π-GST, and calprotectin were markedly increased in the patient group, indicating tubular stress or damage. In contrast, no significant difference was observed in urinary calbindin levels between the groups. Furthermore, biomarker expression did not differ substantially between the severity-based subgroups, suggesting early and consistent release irrespective of clinical progression.
Conclusion: Serum t-CAF and specific urinary biomarkers namely netrin-1, α-GST, π-GST, and
calprotectin demonstrates potential as non-invasive, sensitive indicators of early renal tubular injury in children. Their detection prior to the onset of overt renal dysfunction supports their utility in preclinical screening, facilitating earlier diagnosis and timely clinical intervention in at-risk pediatric populations.
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Dr. Sanobia Farheen
Senior Demonstrator, Biochemistry Department, Multan Medical & Dental College, Multan
Dr Abida jaffar
Senior demonstrator, Biochemistry department NMU Multan
Dr. Nasir Islam
Assistant Professor Biochemistry Department, Multan Medical & Dental College, Multan
Dr Aina khurshid
Assistant professor, Biochemistry Department, Multan Medical & Dental College, Multan
Dr. Muhammad Awais Niaz
Assistant Professor, Pathology Department Al Nafees Medical College & Hospital, Farash Town Phase-1 Islamabad
Dr. Jamal Asad
Assistant Professor , Biochemistry Department, Multan Medical & Dental College, Multan