, Volume 28, Issue 1, pp 161-162

Biomarkers of therapeutic response in primary nephrotic syndrome: response

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To the Editor,

We appreciate Dr. Trachtman’s thoughtful insight [1] into our recent study demonstrating the utility of neutrophil gelatinase-associated lipocalin (NGAL) to discriminate steroid-resistant nephrotic syndrome (SRNS) from steroid-sensitive NS (SSNS) [2]. We are in agreement with several of Dr. Trachtman’s statements. There is potentially great value in biomarkers that can predict whether patients are likely to respond to certain treatments, as it can guide the physician to a clinical course of action that is more likely to succeed. In this instance, the ability to determine whether a patient with NS is likely to respond to steroids can save valuable time and potential side effects of unnecessary exposure to corticosteroids in patients likely to be resistant. That Dr. Trachtman’s team demonstrated urine nitrite levels can distinguish presumed minimal change NS (MCNS) from focal segmental glomerulosclerosis (FSGS) [3] over 15 years ago illustrates that more attention needs to