{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:58:13Z","timestamp":1785329893458,"version":"3.55.0"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Pediatric idiopathic nephrotic syndrome (INS) is classified primarily by corticosteroid response, delaying identification of steroid-resistant disease and exposing children to unnecessary treatment toxicity. Novel biomarkers could enable earlier biological stratification and treatment guidance. Objectives: The study aimed to map available evidence on candidate biomarkers in pediatric INS published since 2020, with emphasis on anti-nephrin autoantibodies and their potential for clinical translation. Data Sources: PubMed\/MEDLINE and Web of Science Core Collection (January 2020\u2013October 2025), with a supplementary verification search in Scopus and Embase and manual reference screening. Eligibility Criteria: Original studies reporting circulating, urinary, or tissue-based biomarkers in children aged 0\u201318 years with idiopathic NS, with outcomes related to diagnosis, treatment response, relapse prediction, or monitoring. Studies in adults only, secondary NS, or animal models were excluded. Results: After screening, 34 studies met the eligibility criteria and were included, grouped into five categories: autoantibodies, urinary markers, immune cell signatures, cytokines\/chemokines, and exploratory markers (metabolomics, extracellular vesicles, lipid profiles, microRNAs). Anti-nephrin IgG emerged as the most mechanistically informative marker, with seroprevalence declining across phenotypes (SSNS 68%, SDNS 28%, non-genetic SRNS 14%, genetic SRNS 2%) and positivity predicting response to intensified immunosuppression. Of the candidates reviewed, urinary NGAL and peripheral B-cell subset monitoring are the most readily implementable with existing laboratory infrastructure. Conclusions: Pediatric INS encompasses a spectrum of immune-mediated podocytopathies that may soon be distinguishable by emerging biomarker profiles. Anti-nephrin autoantibodies provide the strongest mechanistic evidence for an autoimmune podocytopathy.<\/jats:p>","DOI":"10.3390\/medsci14040448","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:45:14Z","timestamp":1785325514000},"page":"448","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Steroid Trial: A Scoping Review of Biomarkers for Pediatric Nephrotic Syndrome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0243-2643","authenticated-orcid":false,"given":"Tudor-Ilie","family":"Lazaruc","sequence":"first","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-9898","authenticated-orcid":false,"given":"Anca-Lavinia","family":"Lazaruc-Postolache","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iuliana-Magdalena","family":"Starcea","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana-Alexandra","family":"Bogos","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Adriana","family":"Mocanu","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina-Andreea","family":"Beldie","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrith-Crenguta","family":"Miron","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania"},{"name":"Emergency Clinical Hospital for Children \u201cSt. Mary\u201d Iasi, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2020029249","DOI":"10.1542\/peds.2020-029249","article-title":"Incidence and Relapse of Idiopathic Nephrotic Syndrome: Meta-Analysis","volume":"148","author":"Veltkamp","year":"2021","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.2215\/CJN.00380116","article-title":"Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome","volume":"11","author":"Banh","year":"2016","journal-title":"Clin. J. Am. Soc. 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