Assessment of subclinical atherosclerosis and cardiovascular disease in children and adolescents with nephrotic syndrome: a systematic review and meta-analysis.
Agni Glava, Anastasia Stoimeni, Nikolaos Gkiourtzis et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis examined subclinical atherosclerosis and cardiovascular markers in children and adolescents under 18 years with nephrotic syndrome (NS), compared with healthy controls. Across 16 observational studies involving 668 patients with NS and 793 controls, cIMT was higher in the NS group (MD = 0.06 mm; 95% CI: 0.05-0.07; p < 0.001), with substantial heterogeneity. No statistically significant differences were found in carotid-femoral pulse wave velocity or left ventricular mass index. cIMT was moderately correlated with disease duration and number of relapses.
Key findings
- cIMT was higher in children with NS than in controls (MD = 0.06 mm; 95% CI: 0.05-0.07; p < 0.001).
- No statistically significant differences were observed in carotid-femoral pulse wave velocity or left ventricular mass index.
- cIMT correlated with disease duration (r = 0.47) and number of relapses (r = 0.45).
- A small positive correlation was found between cIMT and triglycerides, but not total or LDL cholesterol.
Why it matters
The findings suggest that children with NS may show early vascular changes, although the evidence concerns surrogate markers rather than cardiovascular events. The association of cIMT with disease duration and relapses may help frame questions about cumulative disease burden and cardiovascular risk. Whether these markers predict future disease remains uncertain and requires prospective longitudinal study.
What to keep in mind
Included studies were observational and predominantly cross-sectional, with substantial heterogeneity and diverse populations. NS phenotypes and treatment regimens were often poorly characterized or insufficiently reported.