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Idiopathic nephrotic syndrome (INS) is characterized by marked urinary excretion of albumin and other intermediate-sized plasma proteins,such as transferrin and vitamin D-binding protein.Some cases even develop anemia.The aim of this study was to investigate the changes in serum iron,transferrin,and erythropoietin,and the relationships between serum and urine transferrin and erythropoietin.Thirty-seven children with INS and 35 age- and sex-matched healthy children were investigated.The indexes related to iron metabolism,including serum iron,ferritin,transferrin,total iron-binding capacity (TIBC),transferrin saturation,and hematological parameters [hemoglobin (Hb),mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH)],and urinary transferrin.and erythropoietin were measured in 37 children with INS before treatment and at the remission stage.Thirty-five age- and sex-matched healthy children served as controls.Serum iron levels (18.8±3.8)μmol/L in INS patients before treatment were significantly lower than those of the healthy controls (22.2±3.8)μmol/L and those measured at the remission stage (21.0±3.5)μmol/L (all P＜001).Serum transferrin levels in INS patients before therapy (1.9±0.3) g/L also decreased compared with the healthy controls (3.1±0.5) g/L and the measures at the remission stage (2.9±0.6) g/L (all P＜0.01).In contrast,serum TIBC and transferrin saturation were significantly higher in INS patients before treatment than in the healthy controls [TIBC (56.4±9.2)μmol/L vs (50.7±6.8)μmol/L,P＜0.01;transferrin saturation (55.7±9.2)% vs (46.4±8.2)%,P＜0.01] and they were also higher than the measures at remission stage [(51.9±7.7) μmol/L and (47.4±13.3)μmol/L] (all P＜0.01).Serum transferrin was positively correlated with serum albumin (r=0.609,P＜0.01) and negatively correlated with urinary transferrin (r=-0.550,P＜0.01)in INS patients before treatment.We conclude that serum iron,transferrin and erythropoietin levels are markedly decreased in INS patients,which may be partially related to the urinary loss of these indexes.