Introduction: Studies on the status of trace elements and minerals in pediatric patients with idiopathic nephrotic syndrome (INS) are lacking. 
Aim of the Study: To study trace element status in a cohort of children with INS and the relationship with INS activity to advise the need for monitoring & supplementation during the disease course.
Methods: Material and methods: We studied 191 children with INS and 105 healthy children as a control group from two pediatric nephrology centers. We divided them into two groups: 86 patients in the relapse group and 105 patients in the remission group. We measured the serum levels of Zinc (Zn), Copper (Cu), Selenium (Se), Manganese (Mn), Iron (Fe), Calcium (Ca), Phosphorus (P), and Magnesium (Mg) in all of them.
Results: Significantly lower serum levels of Zn, Cu, and Fe levels were observed in patients with active disease than in the other groups, without remarkable differences between the remission and control groups. Significantly lower serum Ca, Mg, and Se serum levels were in the active disease group than those in remission and lower in the two disease groups than in the controls. Serum Mn and P were significantly elevated in patients with activity compared to those in remission and higher in the two groups than in the controls. Significant correlations were found between proteinuria & the studied elements except for Mn.
Conclusion: Children with INS have low levels of Zn, Cu, Fe, Se, Ca & Mg, while high levels of P & Mn during proteinuria. Follow-up of mineral & trace elements in children with Nephrotic Syndrome may be recommended, especially in patients with prolonged proteinuria.