Data Sheet 1_Prevalence of histopathological subtypes associated with steroid-resistant nephrotic syndrome in children: a systematic review and meta-analysis.pdf

BackgroundSteroid-resistant nephrotic syndrome (SRNS) in children is associated with various histopathological subtypes;however, the prevalence of these subtypes remains insufficiently defined. These subtypes often demonstrate variable responses to identical therapeutic regimens and are indicative of distinct clinical outcomes. This systematic review and meta-analysis seeks to comprehensively elucidate the prevalence of the most common histopathological subtypes in pediatric SRNS, offering valuable insights that may inform future therapeutic strategies and improve prognostic predictions for affected patients.
MethodsWe conducted a comprehensive literature search across four major databases: PubMed, Embase, Web of Science, and Cochrane, with coverage extending from the inception of these databases up to December 2023. Two independent researchers screened the identified studies, selecting only cross-sectional and longitudinal studies that reported the prevalence of histopathological subtypes in pediatric SRNS. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and only those meeting the required quality criteria were included. Data were extracted from the selected studies using a standardized data extraction form. Meta-analysis was performed with Stata software to estimate the prevalence of different histopathological subtypes in pediatric SRNS. Subgroup analyses were conducted to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and the Begg test, and sensitivity analysis was also conducted.
ResultsThe most commonly reported histopathological subtypes associated with SRNS in children are focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), minimal change disease (MCD), mesangioproliferative glomerulonephritis (MesPGN), and membranoproliferative glomerulonephritis (MPGN). Among these, the subtype with the highest average prevalence is FSGS, at 39%, followed by MCD (27%), MesPGN (23%), MPGN (18%), and MN (4%).
ConclusionFSGS exhibits a notably high prevalence in SRNS and remains the most frequently observed histopathological lesion associated with this condition.
Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251000869, identifier CRD420251000869.

背景：儿童类固醇耐药性肾病综合征（SRNS）存在多种组织病理学亚型，但目前对这些亚型的患病率尚缺乏充分的明确界定。不同亚型对同一治疗方案常表现出异质性应答，并提示截然不同的临床结局。本项系统评价与荟萃分析旨在全面阐明儿童SRNS最常见组织病理学亚型的患病率，为未来制定治疗策略、改善受累患者的预后预测提供有价值的参考依据。
方法：本研究对PubMed、Embase、Web of Science及Cochrane四大主流数据库进行了全面的文献检索，检索时限设置为各数据库建库至2023年12月。由两名独立研究者对检索得到的文献进行筛选，仅纳入报告了儿童SRNS组织病理学亚型患病率的横断面研究与纵向研究。采用约翰·布里格斯研究所关键评价清单（Joanna Briggs Institute Critical Appraisal Checklist）对纳入研究的质量进行评估，仅纳入符合质量标准的研究。使用标准化数据提取表从入选研究中提取数据。采用Stata软件开展荟萃分析，以估算儿童SRNS不同组织病理学亚型的患病率。同时进行亚组分析以探索潜在的异质性来源，采用漏斗图与Begg检验评估发表偏倚，并开展敏感性分析。
结果：儿童SRNS相关的最常报道的组织病理学亚型包括局灶节段性肾小球硬化（focal segmental glomerulosclerosis, FSGS）、膜性肾病（membranous nephropathy, MN）、微小病变肾病（minimal change disease, MCD）、系膜增生性肾小球肾炎（mesangioproliferative glomerulonephritis, MesPGN）以及膜增生性肾小球肾炎（membranoproliferative glomerulonephritis, MPGN）。其中平均患病率最高的亚型为FSGS，达39%，其次依次为MCD（27%）、MesPGN（23%）、MPGN（18%）及MN（4%）。
结论：FSGS在儿童SRNS中患病率显著偏高，仍是该疾病最常见的组织病理学病变类型。
系统评价注册信息：https://www.crd.york.ac.uk/PROSPERO/view/CRD420251000869，注册号为CRD420251000869。