Thromboembolism due to nephrotic syndrome among children; a systematic review and meta-analysis

Abstract

The importance of nephrotic syndrome among children is mostly due to its related life-threatening events such as thromboembolic events. The present review attempted to systematically assess the pooled prevalence of thromboembolism in nephrotic syndrome among children. This study was performed according to established methods and in compliance with PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis) Protocols. Two investigators searched Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane databases for all eligible studies in accordance with the considered keywords including “thromboembolism”, “nephrotic syndrome”, and “child”. Of total 99 studies that initially assessed based on the keywords published, 11 met the endpoints (published from 1973 to 2012) that were finally analyzed. The data of 5085 children who suffered nephrotic syndrome were assessed. The number of patients in the studies ranged 26 to 3377. The pooled prevalence of thromboembolic events due to nephrotic syndrome among children was estimated to be 6.0% (95% CI: 3.0% to 11.4%). The heterogeneity was high with an I2 of 92.73% (P<0.001) for assessing the pooled prevalence of thromboembolic events in infantile nephrotic syndrome with the stud-related weight ranged 1.40% to 43.08%. There was a significant publication bias as evidenced by either funnel plot asymmetry or Egger test (P=0.156). The overall prevalence of nephrotic syndrome nephrotic syndrome children widely ranges 1.40% to 43.08%, however high heterogeneity obtained by reviewing the literature emphasizes the necessity for further assessment of this event among children from the point of view of etiological and pathophysiological basis. 

Keywords: Nephrotic syndrome, Thromboembolism, Children, Thromboembolic events