A Systematic Review on the Risk Factors of Steroid-Sensitive Nephrotic Syndrome Relapse in the Pediatric Population

Background and objectives: Identifying affecting and predictive factors of steroid sensitive nephrotic syndrome’s (SSNS) outcome may greatly benefit the proper management of SSNS patients. The current systematic review comprehensively reviews all available evidence on the risk factors of SSNS relapse in children and adolescents. Methods: An extensive search was conducted on the electronic databases of Medline, Embase, Web of Science, and Scopus until February ۱۸, ۲۰۲۴. Studies investigating the risk factors of relapse were included in this systematic review. The study was approved by Tehran University of Medical Sciences Ethics Committee (TUMS) (IR.TUMS.CHMC.REC.۱۳۹۷.۰۳۳). Results: Eleven articles were included. The included articles show that age, gender, and laboratory variables such as serum creatinine and serum protein are not risk factors for relapse. Possible associations were reported for risk factors such as number of relapse and time to response. Overall, the studies reported conflicting results on the value of relapse risk factors. Conclusion: Our results show that although factors such as hematuria, hypertension, time from treatment to response, and number of relapses have been proposed as possible risk factors of relapse, no conclusion can be reached due to the heterogeneity of studies. Future studies should have more conforming designs to make comparisons more reliable.

Keywords:

Nephrotic syndrome , Steroid sensitive nephrotic syndrome , Risk factor , Recurrence ​​​​​