Authors
Leah Hernandez, Camillo Tancredi Strizzi, Ylva Tranæus Lindblad, Peter Stenvinkel, Peter Barany, Milan Chromek, Karolina Kublickiene
Published in
Pediatric nephrology (Berlin, Germany). Jul 01, 2026. Epub Jul 01, 2026.
Abstract
Chronic kidney disease (CKD) in children exposes the developing brain to uremic and vascular insults, yet blood-based markers of the pediatric kidney-brain axis remain underexplored. We characterized neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) across the spectrum of pediatric kidney disease.
Prospective cohort of 75 children with measured GFR: 12 comparators with normal kidney function, 31 with non-dialysis CKD stages G2-G5, and 32 kidney transplant recipients (KTx). Biomarkers were measured by ELISA at baseline and after 3.2 years. Cross-sectional and longitudinal analyses adjusted for age and group.
NSE correlated inversely with age (r = - 0.46, p < 0.001) and did not differ between groups after age adjustment. NSE-age slopes were comparable in comparators and CKD but flat in transplanted children, indicating loss of the developmental decline in this group. BDNF correlated positively with measured GFR (r = 0.31, p = 0.018) and was lower in CKD than in comparators, consistent with reduced neurotrophic reserve in pediatric uremia.
Circulating NSE in childhood reflects developmental stage rather than CKD status. Group comparisons in pediatric biomarker studies require age adjustment. Transplantation alters the NSE-age relationship beyond what kidney function explains. BDNF tracks kidney function in pediatric CKD. Age-stratified reference intervals are required before either marker can guide clinical decisions.
PMID:
42384094
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.
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