The Risk Factors Of Urinary Tract Infection In Children With Primary Nephrotic Syndrome: A Meta-analysis

Objective: To systematically analyze the risk factors of urinary tract infection(UTI)in children with primary nephrotic Syndrome(PNS),in order to provide the scientific evidence of clinical prevention.Methods: Eight databases including PubMed,Embase,the Cochrane Libray,Web of science,China National Knowledge Infrastructure,WanFang Database,Chinese Science and Technology Periodical Database and Chinese Biological Medical Literature Database were searched for the case-control studies about PNS complicated with UTI in children.According to the inclusion and exclusion criteria,eligible studies were selected for meta-analysis using RevMan 5.3 software.Results: Finally,twelve case-control studies were included,917 children in the case group and 2784 children in the control group.Compared with children with non-UTI,there was statistically significant difference in children with UTI of elevated 24-hour urine protein[Standardized Mean Difference(SMD)0.45,95% Credibility Interval(CI),0.02 to 0.88],decreased serum albumin(SMD-1.06,95%CI,-1.14 to-0.97),elevated serum cholesterol [Weighted Mean Difference(MD)2.28,95%CI,1.61 to 2.95],elevated serum Low density lipoprotein(SMD 0.57,95%CI,0.37 to 0.77],decreased plasma IgG(SMD-0.76,95%CI,-0.94 to-0.58),elevated plasma IgM(MD 0.28,95%CI,0.11 to 0.46),high-dose hormone(MD 0.75,95%CI,0.58 to 0.92),and long time hormone use[<15d Odds Ratio(OR)0.20,95%CI,0.10 to 0.42;≥15d OR 5.00,95%CI,2.38 to 10.50].Conclusion: Massive proteinuria,hypoalbuminaemia,hypercholesterolemia,high level of low density lipoprotein,decreased plasma IgG,high-dose hormone and long time hormone use are risk factors of UTI in children with PNS.