Abstract Nephrotic syndrome (NS) is a common childhood glomerulopathy characterized by significant proteinuria but lacks reliable biomarkers of relapse or prognosis. Extracellular vesicles (EVs) are membrane-bound particles released from stressed cells that carry molecular cargo reflective of cellular state. We previously demonstrated increased podocyte-specific urinary EVs in children with NS during relapse, with levels returning to near-zero during remission. Building on this observation, we e