EARLY DETECTION OF RENAL TUBULAR DISORDERS USING BIOCHEMICAL MARKERS IN CHILDREN BELOW AGE OF 12 YEARS IN SOUTHERN PUNJAB, PAKISTAN
Main Article Content
Keywords
Renal Tubular Disorders, Biochemical Markers, Children <12 years
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 netrin1, 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,
