Meta Analysis Of The Risk Factors For Kidney Damage To Henoch-Schonlein Purpura In Children

ObjectivesTo discuss the risk factors for kidney damage to the Henoch-Schonlein purpura in children.Data and MethodsIn this study, with developed strict inclusion and exclusion criteria, systematic evaluation was used to collect all documents on the risk factors for kidney damage to the Henoch-Schonlein purpura.Search the Chinese Academic Literature Main Storehouse, Chinese Science and Technology Periodical Database, Ten Thousand Side Periodicals and the Dissertation Database, the Chinese Biomedicine Literatuie Database comprehensively, CALIS foreign periodicals nets and duxiu academic search, besides, retrospective retrieval and manual retrieval were also used. From the published and the unpublished theories dating from January2000to October2011, the clinical materials and informations about the high risk for kidney damage to the HSP were collected. Include in the original study, evaluate the quality, extract the information and check over, then remove documents which were inappropriate for the purposes and standards of the study, finally confirm the study.RavMan4.2provided by Cochrane was used for Meta Analysis. Select fixed or random model according to the literature results of heterogeneity test. Sensitivity analysis is done according to the different results. The publication bias is evaluated by funnel plots. Odds Ratio(OR) and95%Confidence Interval(CI) were estimated in the dissertation.Results13studies including a total of4322cases of patients meet the inclusion criteria. And1481cases of patients with kidney damage were confirmed.All of the13studies were retrospective studies.OR and95%CI were as follows:Age>=10year:OR=3.18,95%CI=[1.86-5.43],Z=4.24,p<0.00001；Male gender:OR=1.22,95%CI.[0.93-1.60],Z=1.45,p=0.15；Abdominal pain:OR:2.07,95%CI=[1.40-3.07],Z=3.64,p=0.0003；Arthralgia:OR=1.17,95%CI=[0.94-1.45],Z=1.44,p=0.15；Gastrointestinal bleeding:OR=2.10,95%CI=[1.61-2.74],Z=5.44,p<0.00001:Purpura repeatedly:OR=3.64,95%CI=[2.66-4.98],Z=8.07,p<0.00001；WBC>10×109/L:OR=1.05,95%CI=[0.83-1.31],Z=0.39,p=0.70；PLT>300×109/L:OR=1.07,95%CI=[0.84-1.38],Z=0.55,p=0.41.Conclusions1.Based on the eight risk factors found that the high risk factors for kidney damage to Henoch-Schonlein purpura are Age>=10year,Abdominal pain, Gastrointestinal bleeding and Purpura repeatedly.2. OR as a effective index,according to the Wynder standard,the correlation between Abdominal pain,Gastrointestinal bleeding and kidney damage to Henoch-Schonlein purpura is moderate;the correlation between Age>=10year, Purpura repeatedly and kidney damage to Henoch-Schonlein purpura is strong.3. Because all of the13studies were retrospective studies,and maybe there was some omission in the design,some kinds of bias could arise.As a result,further conclusions need to be drawn through a number of well-designed,large sample prospective studies.