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Oxidative stress is increasingly recognized as a relevant factor in its etiopathogenesis, and reliable noninvasive indicators could simplify assessment of disease activity and treatment response. This longitudinal case follows a 10.7-year-old boy with five clinical time points within one year, using FRAS5 to measure OSI, PAT and d-ROM biomarkers. The patient showed low antioxidant defense with increased OSI during relapses, shifting toward reduced oxidative burden and improved defense during remission, with redox dynamics linked to glucocorticoid therapy and disease activity. d-ROM, PAT and OSI may support dynamic tracking of pediatric INS activity, response, and residual oxidative burden, warranting further research for broader clinical decision-making.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/dynamic-changes-in-oxidative-stress-biomarkers-in-a-child-with-idiopathic-nephrotic-syndrome-a-longitudinal-case-study/465178/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/dynamic-changes-in-oxidative-stress-biomarkers-in-a-child-with-idiopathic-nephrotic-syndrome-a-longitudinal-case-study/465178.png","ImageObject",300,407,{"name":92,"@type":93},"Genevieve","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main aim of this longitudinal case study?","Question",{"text":112,"@type":113},"To track dynamic oxidative stress biomarker changes in a child with idiopathic nephrotic syndrome across multiple clinical time points over one year.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which biomarkers were measured and how were they calculated?",{"text":117,"@type":113},"Using the FRAS5 analyzer, the study measured oxidative stress index (OSI), plasma antioxidant capacity (PAT), and derivatives of reactive oxygen metabolites (d-ROMs). OSI was computed as the d-ROM/PAT ratio × 100.",{"name":119,"@type":110,"acceptedAnswer":120},"How did oxidative stress biomarkers change between relapse and remission?",{"text":121,"@type":113},"During relapses, the patient had low antioxidant defense with moderate oxidative status and increased OSI. During remission, the profile showed a positive transition to reduced oxidative burden and enhanced defense.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},465178,1792233991,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374391974585,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Case Report  \nDynamic Changes in Oxidative Stress Biomarkers in a Child with Idiopathic Nephrotic Syndrome: A Longitudinal Case Study  \nJoško Osredkar 1,2 and Matjaž Kopaˇc 3,4, *  \nAcademic Editor: Yaochun Zhang  \nReceived: 18 November 2025  \nRevised: 23 December 2025  \nAccepted: 24 December 2025  \nPublished: 24 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Zaloška Cesta 2, 1525 Ljubljana, Slovenia; [josko.osredkar@kclj.si](josko.osredkar@kclj.si)  \n2 Faculty of Pharmacy, University of Ljubljana, Aškerˇceva 7, 1000 Ljubljana, Slovenia  \n3 Department of Nephrology, Division of Paediatrics, University Medical Centre Ljubljana, Bohoriˇceva 20, 1525 Ljubljana, Slovenia  \n4 Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia  \n* [Correspondence: matjaz.kopac@siol.net](Correspondence: matjaz.kopac@siol.net); Tel.: +386-15229626  \nAbstract  \nIdiopathic nephrotic syndrome (INS) is the most prevalent glomerular illness in children. Even while immunologic processes are well-established, oxidative stress is becoming more widely acknowledged as a significant factor in the etiopathogenesis of illness. Assessing its activity and treatment response may be made easier with the use of trustworthy, noninvasive indicators to track redox balance. We report on the oxidative stress levels of a 10.7-year-old boy with INS with five clinical time points in one year. The FRAS5 analyzer was used to calculate the oxidative stress index (OSI), plasma antioxidant capacity (PAT) and derivatives of reactive oxygen metabolites (d-ROMs) as biomarkers. A 4-tier oxidative state classification scheme based on d-ROM and PAT thresholds was used to interpret the values. The patient had low antioxidant defense, moderate oxidative and increased OSI at relapses, a positive transition to reduced oxidative burden and enhanced defense during remission. The order of events showed a dynamic redox response associated with glucocorticoid (GC) medication and disease activity. The potential value of d-ROM, PAT, and OSI as dynamic biomarkers for tracking disease activity, response to treatment and residual oxidative burden in pediatric INS is supported by this case. To confirm their function in more comprehensive clinical decision-making, more research is required.  \nKeywords: idiopathic nephrotic syndrome; child; oxidative stress; reactive oxygen species; derivatives of reactive oxygen metabolites; plasma antioxidant capacity; oxidative stress index; glucocorticoid therapy; redox biomarkers  \n1. Introduction  \nThe most prevalent glomerular illness in children is idiopathic nephrotic syndrome (INS), which is characterized by widespread edema, hypoalbuminemia, pronounced proteinuria and hyperlipidemia [1] . The disease is chronic and recurrent, and a small percentage of individuals experience glucocorticoid (GC) dependence or resistance, even thoughthe majority of cases respond effectively to GC therapy [2] . Although the exact pathophysiology is yet unknown, evidence points to an immunologically driven breakdown of the glomerular filtration barrier, involving altered charge selectivity of the glomerular basement membrane (GBM) and podocyte damage [3,4] .  \nThe most common histological form of INSin children, minimal change disease (MCD), shows effacement of podocyte foot processes on electron microscopy but no discernible structural alterations on light microscopy [5] . Damage to the slit diaphragm and podocyte cytoskeleton increases permeability to macromolecules like albumin [6] . Although glomerular integrity is thought to be disrupted by immunologic triggers, specifically T-cell-derived cytokines, genetic predisposition involving podocyte proteins (e.g., nephrin, podocin) has also ","cbCaioRzPFST2kil","https://ap.wps.com/l/cbCaioRzPFST2kil","pdf",362267,11,"English","# Introduction\n## Oxidative stress and oxidative-state biomarkers\n## Current biomarkers and their limitations\n## Longitudinal case study context","[{\"question\":\"What was the main aim of this longitudinal case study?\",\"answer\":\"To track dynamic oxidative stress biomarker changes in a child with idiopathic nephrotic syndrome across multiple clinical time points over one year.\"},{\"question\":\"Which biomarkers were measured and how were they calculated?\",\"answer\":\"Using the FRAS5 analyzer, the study measured oxidative stress index (OSI), plasma antioxidant capacity (PAT), and derivatives of reactive oxygen metabolites (d-ROMs). OSI was computed as the d-ROM/PAT ratio × 100.\"},{\"question\":\"How did oxidative stress biomarkers change between relapse and remission?\",\"answer\":\"During relapses, the patient had low antioxidant defense with moderate oxidative status and increased OSI. During remission, the profile showed a positive transition to reduced oxidative burden and enhanced defense.\"}]","Dynamic Changes in Oxidative Stress Biomarkers in a Child with Idiopathic Nephrotic Syndrome - A Longitudinal Case Study | PDF",1790769275,28]