A DNA helix transforming into a healthy kidney, symbolizing personalized medicine for kidney disease.

Decoding Kidney Disease: Can Genes Predict Treatment Success?

Mira Elwood in Health & Wellness August 2025 • 4 min read.

"New research explores how specific genes influence treatment response in children with nephrotic syndrome, offering hope for personalized medicine."

Nephrotic syndrome (NS) is a common kidney disorder in children, where the kidneys leak protein into the urine. While most children initially respond well to steroid treatment, many experience relapses or become resistant to steroids altogether. This can lead to long-term kidney damage and the need for more aggressive treatments. The big question is: why do some children respond to standard treatment while others don't?

Researchers have been exploring the role of genetics in predicting treatment outcomes for NS. One area of focus is the MDR1 gene, which is involved in how the body processes and eliminates certain drugs, including steroids. Variations in this gene, called polymorphisms, could affect how well steroids work in treating NS.

A recent study investigated the link between MDR1 gene polymorphisms and treatment response in Slovak children with NS. The goal was to see if specific genetic variations could predict whether a child would respond to prednisone, a common steroid medication used to treat NS. This article breaks down the study's findings and what they might mean for the future of personalized medicine in treating childhood kidney disease.

How do Genes Impact Steroid Treatment in Kidney Disease?

A DNA helix transforming into a healthy kidney, symbolizing personalized medicine for kidney disease.

The study, published in Medical Science Monitor, analyzed the MDR1 gene in 46 children with NS and 100 healthy children. The researchers looked at three specific polymorphisms (1236T>C, 2677T>G, and 3435T>C) and how they related to treatment response, demographic factors, and pathological characteristics.

The researchers used a method called polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to analyze the MDR1 gene. Then, they dug deep using different genetic models to understand the associations.

3435TC Genotype: Children with the 3435TC genotype had a significantly higher chance of responding to prednisone treatment.
MDR1 1236CC and 2677GG: Children under 6 with NS had lower frequencies of MDR1 1236CC and 2677GG genotypes.
Histology Matters: Children with minimal change disease (MCD) responded better to initial treatment compared to those with focal segmental glomerulosclerosis (FSGS).

These results suggest that the MDR1 3435T>C polymorphism, along with the child's age at diagnosis and the specific type of kidney damage (histology), may influence how well they respond to prednisone. In simple terms, a child's genetic makeup and the characteristics of their kidney disease could help doctors predict whether steroid treatment will be effective.

Personalized Medicine for Kidney Disease: What's Next?

This study is an important first step in understanding how genetics can play a role in treating childhood NS. However, the researchers emphasize that larger, multi-center studies are needed to confirm these findings and explore how they apply to different ethnic groups. It's also important to remember that this is just one piece of the puzzle.

While genetic testing isn't yet a standard part of NS treatment, this research suggests that it could be in the future. By identifying children who are less likely to respond to steroids, doctors could explore alternative treatments earlier, potentially preventing long-term kidney damage.

Ultimately, the goal is to move towards a more personalized approach to treating NS, where treatment decisions are tailored to each child's individual characteristics, including their genetic makeup, age, and the specific type of kidney disease they have.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.12659/msm.891366, Alternate LINK

Title: Mdr1 Polymorphisms And Idiopathic Nephrotic Syndrome In Slovak Children: Preliminary Results

Subject: General Medicine

Journal: Medical Science Monitor

Publisher: International Scientific Information, Inc.

Authors: Ladislav Mirossay

Published: 2015-01-01

Everything You Need To Know

What exactly is nephrotic syndrome in children, and why is it so important to understand how it responds to treatment?

Nephrotic syndrome is a kidney disorder in children where the kidneys leak protein into the urine. While many children initially respond well to steroid treatment, some experience relapses or become resistant to steroids. This can lead to long-term kidney damage and the need for stronger treatments. The variability in treatment response is a key question driving research in this area.

How does the MDR1 gene relate to how children respond to steroid treatments like prednisone for nephrotic syndrome?

The MDR1 gene plays a role in how the body processes and eliminates drugs, including steroids like prednisone. Variations in the MDR1 gene, called polymorphisms, can affect how well steroids work in treating nephrotic syndrome. Specific polymorphisms like 3435T>C, 1236T>C, and 2677T>G are being studied to understand their impact on treatment response.

What were the key genetic findings in the study regarding the MDR1 gene and its link to treatment response in children with nephrotic syndrome?

The study found that children with the 3435TC genotype had a higher likelihood of responding to prednisone treatment. Also, children under 6 with nephrotic syndrome had lower frequencies of MDR1 1236CC and 2677GG genotypes. Furthermore, children with minimal change disease (MCD) responded better to initial treatment compared to those with focal segmental glomerulosclerosis (FSGS). These factors, including genetics and kidney damage type, can potentially predict steroid treatment effectiveness.

How can understanding the genetics of nephrotic syndrome lead to more personalized treatment approaches for children affected by this condition?

Personalized medicine in nephrotic syndrome aims to tailor treatment based on individual characteristics, including genetics. By identifying genetic markers like MDR1 polymorphisms that influence treatment response, doctors can potentially predict which children will respond well to standard steroid treatment and which may require alternative approaches from the start. This could minimize exposure to ineffective treatments and reduce the risk of long-term kidney damage. However, additional factors beyond genetics should be considered, because they contribute to the variability in treatment response.

Besides the MDR1 gene, what other factors might influence how children with nephrotic syndrome respond to treatment, and what further research is needed?

While the study focused on the MDR1 gene and its polymorphisms, other genetic factors and environmental influences likely play a role in treatment response in nephrotic syndrome. Future research may explore other genes involved in steroid metabolism or kidney function, as well as environmental factors that could influence treatment outcomes. Multi-center studies across different ethnic groups are needed to validate the findings and develop more comprehensive predictive models that inform personalized treatment strategies.