The Clinical Profile and Prognosis of Chinese Children with Melamine-Induced Kidney Disease: A Systematic Review and Meta-Analysis

Abstract

Introduction. Studies have reported inconsistent results regarding clinical feature and the prognosis status of the affected children in China melamine-contamination event. We summarized available literatures by performing a review and meta-analysis. Methods. Statistical pooling was performed using random-effects model; the sources of heterogeneity were explored through subgroup analyses. Results. Twenty-six studies involving 2164 patients with kidney abnormalities were identified; 94.4% of the patients had urinary calculi and 95.8% of the calculi were <10 mm in diameter. Of 2040 patients with known types of treatment, 5.6% underwent surgical treatment. The pooled recovery rates at 1, 3, 6, and 12 months after diagnosis or treatment initiation were 67.1%, 76.3%, 85.4%, and 92.3%, respectively; these pooled rates did not differ between the study subgroups stratified by mean age at diagnosis, mean duration of melamine exposure, types of patients (inpatient/outpatient), and treatment types (specific/nonspecific), except that the 1-month recovery rate for studies involving a specific treatment (71.9%) was higher than that for studies involving non-specific treatment (46.2%). Conclusion. The majority of patients had small calculi and could recover without surgical treatment. Kidney abnormalities remained in about 8% of the patients at 12-month followup, indicating a need for longer-term followup.

Global dimensions of chronic kidney disease of unknown etiology (CKDu): a modern era environmental and/or occupational nephropathy?

“…Ingestion of formula adulterated with melamine resulted in an outbreak in Chinese infants due to urinary tract obstruction from kidney stones. The long term implications of this exposure remain a research focus [ 41 ]. In a much smaller outbreak, diethylene glycol contaminated acetaminophen syrup caused acute kidney injury in Haitian children.…”

A cross disciplinary study of link decay and the effectiveness of mitigation techniques

“…The result would be a higher probability that the URL would appear as a higher level index page, which are generally more likely to function than pages at lower levels [11,12]. …”

Adverse child health impacts resulting from food adulterations in the Greater China Region

“…In 26 studies of clinical cases of kidney stones, more male patients were recorded than female patients. The male/female ratio was as high as 3.17:1 . Although the lifetime risks of kidney stones among North American and Asian populations are 6–12 and 3–9% respectively, the natural recurrence of kidney stones over 10 years is approximately 50% .…”

“…Urine wileyonlinelibrary.com/jsfa [43][44][45] DEHP and DiNP cause prematurity (before birth) 26,27 Melamine causes kidney stones and inflammation [70][71][72][73][74][75][76][77][78][79][80] Melamine harms the hippocampus and decreases learning abilities [85][86][87][88] is (For males only) Both DEHP and DiNP affect testes weight 29 and Leydig cell function 35 DEHP causes incomplete testicular descent 33,34 DiNP affects epididym weight 29 (For males only) DEHP causes a decrease in penile width and volume, [31][32][33][34] causes hypospadias 20,21 and microalbuminuria 23,24 DEHP is related to ADHD symptoms 51 MEHP is related to ASD symptoms 52 DEHP is related to lower vocabulary and lower intelligence 48,49 DEHP and DiNP enter the body via respiration 7 Melamine, DEHP and DiNP enter the body via food ingestion [7][8][9] DEHP and DiNP enter the body via dermal contact 7 were related to AGD in infants ( Table 6). In a study on rats, animals fed 750 mg kg −1 day −1 between gestation days 13 and 20 showed significant reduction in AGD (P = 0.001).…”

“…The male/female ratio was as high as 3.17:1. 77,78 Although the lifetime risks of kidney stones among North American and Asian populations are 6-12 and 3-9% respectively, the natural recurrence of kidney stones over 10 years is approximately 50%. 79,80 Children who have suffered from kidney stones caused by melamine are likely to redevelop kidney stones in their adolescence.…”