longitudinal analysis of sfas, sfasl, and se-selectin as predictive biomarkers for chronic kidney disease progression in children: progress study

Background: chronic kidney disease (ckd) is a rare condition that causes significant health problems in children.objectives: to evaluate changes in serum and urinary levels of soluble fas (sfas), soluble fas ligand (sfasl), and soluble e-selectin (se-selectin) over time in children with ckd and determine their potential as biomarkers for ckd progression.methods: this longitudinal study was conducted as part of the progress study. a total of 117 patients with ckd and 56 healthy children were included. the ckd cohort underwent a 24-month prospective follow-up. soluble fas, sfasl, and se-selectin levels were measured using the luminex method at baseline, the 12th month, and the 24th month of the study.results: at baseline, patients with ckd had significantly higher serum median levels of sfas, sfasl, and se-selectin compared to the control group (8337 pg/ml vs. 3951 pg/ml, 68 pg/ml vs. 33 pg/ml, and 26460 pg/ml vs. 19801 pg/ml, respectively; p < 0.0001 for all). additionally, the ckd group showed significantly higher urinary ratios of sfas/cr, sfasl/cr, and se-selectin/cr compared to the control group (p < 0.0001 for all). in the ckd group, median serum sfasl levels (68 pg/ml vs. 51 pg/ml) and urinary sfasl/cr ratios (19 pg/mg vs. 14 pg/mg) significantly decreased at the 24th month compared to baseline (p < 0.0001 for both). similarly, serum se-selectin median levels and urinary se-selectin/cr ratios showed significant decreases over time (p = 0.003 and p < 0.0001, respectively). baseline urinary sfas/cr, sfasl/cr, and se-selectin/cr ratios were highest in ckd stages 4 - 5 compared to stages 2, 3a, and 3b (p < 0.0001, p < 0.0001, and p = 0.007, respectively), while no significant differences were observed in baseline serum levels of sfas, sfasl, and se-selectin across ckd stages (p > 0.05). baseline serum sfasl median levels were lower (p = 0.038), while baseline serum sfas median levels were higher (p = 0.045) in patients with rapid ckd progression compared to those without rapid progression. urinary sfas/cr, sfasl/cr, and se-selectin/cr ratios positively correlated with all urinary hsp/cr ratios (p < 0.0001 for all).conclusions: our study highlights that ckd progression is a complex process involving sfas, sfasl, and se-selectin; however, these biomarkers do not serve as predictors of ckd progression.