Kidney Week 2025 Annual Meeting-Moving the Needle in Childhood Nephrotic Syndrome

Video Transcription

Video Summary

The session, moderated by pediatric nephrologists Priya Varghese and Kaye Brathwaite, focused on immune mechanisms and new research strategies in childhood nephrotic syndrome and FSGS.<br /><br />Dr. Rashid Badegeshin reviewed evidence that steroid-sensitive nephrotic syndrome (SSNS) is largely an adaptive immune disease. GWAS consistently show the strongest association in the HLA region, with additional loci (notably CLEC16A) supporting immune dysregulation. He described newer multi-ancestry GWAS meta-analyses and his group’s work developing polygenic risk scores and HLA haplotypes that, combined with age of onset, can modestly predict steroid response—promising but not yet bedside-ready. Discussion highlighted limitations of GWAS for distinguishing relapse biology versus established disease, and the need to integrate genetics with mechanistic studies.<br /><br />Dr. Zubin Modi presented two collaborative research innovations. PARASOL aggregates global FSGS datasets to validate feasible clinical trial endpoints, showing proteinuria reduction predicts kidney survival better than noisy short-term eGFR slope—especially in pediatrics. NEPTUNE MATCH advances precision-medicine trial matching by linking deep molecular profiling with trial enrollment pathways, potentially democratizing access and improving patient–trial alignment.<br /><br />Renal pathologist Dr. Astrid Weins discussed antinephrin antibodies and biopsy “IgG dusting” as tools to stratify diffuse podocytopathies. Antinephrin antibodies are common in nephrotic, treatment-naïve SSNS, drop rapidly after steroids, and may aid diagnosis, prognosis, relapse risk, and transplant recurrence prediction, though assays require standardization and other autoantibodies likely exist.<br /><br />Dr. Eugene Chan summarized collaborative evidence supporting rituximab for frequently relapsing/steroid-dependent NS, noting dosing and maintenance immunosuppression matter, memory B-cell reconstitution may predict relapse better than total B cells, and hypogammaglobulinemia/infection risks warrant monitoring—especially in younger children.

Asset Subtitle

Moderator(s): Kaye Brathwaite, Priya Verghese

Presentation(s):

Immune Architecture of Childhood Nephrotic Syndrome - Rasheed Gbadegesin
Innovative Approaches for Study Design and Collaboration in FSGS: PARASOL Project and NEPTUNE Match - Zubin Modi
Can Antinephrin Antibodies Guide Diagnosis and Treatment of Pediatric Nephrotic Syndrome? - Astrid Weins
Approach to Using Rituximab in Nephrotic Syndrome: Lessons Learned from Collaborative Studies - Yu hin Chan

Meta Tag

Date 11/7/2025

Pathway 1 Pediatric Nephrology

Pathway 2 Glomerular Diseases

Session ID 507340

Keywords

childhood nephrotic syndrome

focal segmental glomerulosclerosis (FSGS)

steroid-sensitive nephrotic syndrome (SSNS)

adaptive immune mechanisms

genome-wide association studies (GWAS)

HLA region association

CLEC16A locus

polygenic risk scores

HLA haplotypes

steroid response prediction

PARASOL FSGS consortium

proteinuria reduction endpoint

NEPTUNE MATCH precision medicine

antinephrin antibodies

rituximab for steroid-dependent nephrotic syndrome