Stage-dependent rise of maresin 1 in pediatric chronic renal failure: Toward a novel diagnostic and therapeutic target

Background Chronic renal failure (CRF) in children is characterized by persistent inflammation and oxidative stress, contributing to progressive loss of renal function and multisystem involvement. Maresin 1 (MaR1), a specialized pro-resolving lipid mediator derived from docosahexaenoic acid (DHA), plays a role in the resolution of inflammation and tissue repair. However, its circulating concentrations in pediatric CRF have not been examined. This study aimed to determine serum MaR1 levels across CRF stages in children and to assess its potential relevance as a biomarker reflecting disease severity. Methods Children were categorized as healthy controls or assigned to CRF stages 1–5 according to estimated glomerular filtration rate (eGFR). Serum MaR1 concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Group comparisons were performed using one-way ANOVA with Tukey’s post-hoc test (p < 0.05). Results Serum MaR1 levels differed significantly among the six groups (p < 0.001). Compared with healthy controls (≈ 110 ± 15 pg/mL), levels were substantially reduced in CRF stages 1–3 (25–70 pg/mL). In contrast, MaR1 concentrations increased in advanced stages, with marked elevations in stage 4 (≈ 200 ± 20 pg/mL) and stage 5 (≈ 300 ± 30 pg/mL). Conclusions Serum MaR1 concentrations show a stage-dependent, biphasic pattern in pediatric CRF, with suppression in early disease and elevation in advanced stages. These findings suggest that MaR1 may reflect underlying inflammatory dynamics in CRF and could merit further investigation as a potential biomarker and therapeutic target.