Disease-Associated Systemic Complications in Childhood Nephrotic Syndrome: A Systematic Review

Dany Hilmanto,1 Fitriana Mawardi,2 Ayuningtyas S Lestari,3 Ahmedz Widiasta1 1Division of Nephrology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Community and Family Medicine Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Yogyakarta, Indonesia; 3Nursing Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Yogyakarta, IndonesiaCorrespondence: Dany Hilmanto, Division of Nephrology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, 38 Jalan Professor Eyckman, Pasteur, Sukajadi, Bandung, West Java, Indonesia, Email danyhilmanto@yahoo.comIntroduction: Nephrotic syndrome (NS) is one of the most common childhood kidney diseases. During the active phase, the disease pathogenesis affects various biological functions linked to loss of proteins negatively, which can result in systemic complications. Complications of childhood NS are divided into two categories: disease-associated complications and drug-associated complications. However, complications in pediatric patients with NS, especially disease-associated complications are still limited. Although reported in the literature, information is not comprehensive and needs to be updated. This study aimed to systematically assess systemic complications in children with NS, especially disease-associated complications, to better understand how they impact outcomes.Methods: We conducted a systematic search of several databases: BioMed Central Pediatrics, PubMed, Google Scholar, the National Library of Medicine, Cochrane Library, CINAHL/EBSCO, British Medical Journal, Science Direct, Scopus, and Elsevier’s ClinicalKey. We followed the PRISMA guidelines to plan, conduct, and report this review. We used the Joanna Briggs Institute’s critical appraisal tools for assuring the quality of the journal articles that were chosen.Results: Eleven articles concerning complications in childhood NS were analyzed. Systemic disease-associated complications in covered were cardiovascular complications, infections, thyroid-hormone complication, kidney complications, and oral health complications.Conclusion: NS is marked by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia, which can result in systemic disease-associated complications. Cardiovascular complications, infections, thyroid-hormone complications, kidney complications, and oral health complications are the main systemic complications in childhood NS. It is essential that health-care providers prevent these complications for proper maintenance of patients’ health.Keywords: disease complications, nephrotic syndrome, pediatric, systemic complications