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The risk factors for children with primary nephrotic syndrome: a systematic review and meta-analysis
Zhifang Zheng1, Guoli Chen2, Xiaoqing Jing1
1Department of Pediatric Medicine, Affiliated Hospital of Chengde Medical College, Chengde, China.
Insights
Low serum albumin, low total protein, high urinary protein, low urea nitrogen, and high cholesterol are key risk factors for primary nephrotic syndrome (PNS) with urinary tract infection (UTI) in children. Identifying these factors aids in early detection and management.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Clinical Biochemistry
Background:
- Primary nephrotic syndrome (PNS) is a significant kidney disorder in children.
- Urinary tract infections (UTIs) can complicate PNS, increasing morbidity.
- Identifying risk factors for concurrent PNS and UTI is crucial for effective management.
Purpose of the Study:
- To evaluate the risk factors associated with primary nephrotic syndrome (PNS) in children who also develop urinary tract infections (UTIs).
- To identify specific biochemical markers that indicate an increased risk of concurrent PNS and UTI in pediatric patients.
Main Methods:
- A systematic meta-analysis was conducted using multiple databases (PubMed, EMBASE, WOS, Cochrane Library, CNKI).
- Included studies compared pediatric patients with PNS and UTI to those with PNS alone.
- Data analysis involved quality assessment, meta-analysis using Review Manager, sensitivity, and bias analyses.
Main Results:
- Eight studies involving 3,274 patients were analyzed.
- Key risk factors identified include low serum albumin, low serum total protein, high urinary protein, low serum urea nitrogen, and high serum cholesterol.
- Statistical significance was observed for all identified risk factors (P<0.05).
Conclusions:
- Low serum albumin, low serum total protein, high urinary protein, low serum urea nitrogen, and high serum cholesterol are significant risk factors for PNS with UTI in children.
- These findings can guide clinical practice for risk stratification and early intervention in pediatric nephrotic syndrome.
Background:
To evaluate the risk factors of primary nephrotic syndrome (PNS) with urinary tract infection (UTI) in children.
Methods:
Multiple databases including PubMed, Excerpta Medica Database (EMBASE), Web of Science (WOS), the Cochrane Library, and China National Knowledge Infrastructure (CNKI) were used to search for relevant studies, which were full-text articles involved in the evaluation of differences between PNS with UTI and without UTI. All included articles were assessed for quality and the data analyses were conducted with Review Manager (5.4). Forest plots, sensitivity analysis, and bias analysis were also performed on the included articles.
Results:
Eight studies were included in this meta-analysis, with a total of 3,274 patients. Meta-analysis showed that a low level of serum albumin [mean difference (MD): -0.32 g/dL; 95% confidence interval (CI): (-0.55, -0.08); P=0.008], a low level of serum total protein [MD: -0.16 g/dL; 95% CI: (-0.20, -0.12); P<0.00001], a high level of urinary protein [MD: 5.09 mg/d; 95% CI: (3.13, 7.05); P<0.00001], a lower level of serum urea nitrogen [MD: -0.10 mg/dL; 95% CI: (-0.18, -0.02); P=0.01], and a higher level of serum cholesterol [MD: 2.26 mg/dL; 95% CI: (0.74, 3.78)] had a higher risk of PNS with UTI. There was no obvious publication bias among included studies.
Discussion:
Our research demonstrated that a low level of serum albumin, a low level of serum total protein, a high level of urinary protein, a low level of serum urea nitrogen, and a high level of serum cholesterol were the risk factors of PNS with UTI in children.
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