Varying zinc levels in pediatric nephrotic syndrome patients and its correlation with remission and relapse: An observational study

Mishra, Nandita; Shrivastava, Anubha; Tiwari, A D; Yadav, R K; Maurya, Manisha

doi:10.18231/j.pjms.2022.018

Cited by 1 publication

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“…As indicated in Table 1 , the eight selected full-text articles consist of four RCTs, 18 , 19 , 24 , 25 one case-control study, 16 a prospective, non-comparative study, 26 a cross-sectional study, 27 and an observational study. 28 The studies were conducted in Iraq 16 and Iran 26 , 27 and in Asian countries, namely Pakistan, 18 , 25 Bangladesh, 24 and India. 19 , 28 The study settings were all hospital-based.…”

Section: Resultsmentioning

confidence: 99%

“… 28 The studies were conducted in Iraq 16 and Iran 26 , 27 and in Asian countries, namely Pakistan, 18 , 25 Bangladesh, 24 and India. 19 , 28 The study settings were all hospital-based. The total number of participants in the eight studies was 627.…”

Section: Resultsmentioning

confidence: 99%

“…They presented variable age and sex distributions. For instance, different age ranges were reported: < 5–10 years, 28 2–10 years, 24 2–15 years, 18 2–14 years, 16 and 1–16 years. 19 Other studies documented the participants’ mean ages as 6.38 ± 3.42 years, 25 6.5 ± 3.7 years, 26 and 6.2 ± 3.2 years.…”

Section: Resultsmentioning

confidence: 99%

“…Jaiswal et al estimated serum zinc levels during the initial episode/relapse and remission in 49 children with idiopathic nephrotic syndrome and correlated these variables with time to remission. 28 The authors measured serum zinc levels at confirmation of the initial episode/relapse and repeated the estimation at remission: using serum zinc level at remission as the study endpoint. They found that serum zinc level was inversely correlated to the time of remission, although the relationship was not significant.…”

Section: Resultsmentioning

confidence: 99%

“…16 In Table 2, the quality assessment of four of the eight studies using the Newcastle-Ottawa Scale shows a star rating of ≥ 7 (high quality) for one study 16 while the remaining studies are rated < 7 (low quality). [26][27][28] The latter had no study comparators or controls. Thus, assessment parameters like selection and comparability of cases and controls did not apply to these studies: precluding star rating on items under these parameters.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 4 more Smart Citations

Can Oral Zinc Supplementation Reduce Relapses in Childhood Steroid-Sensitive Nephrotic Syndrome? A Systematic Review

Mbanefo¹,

Uwaezuoke²,

Eneh³

et al. 2023

IJNRD

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Introduction Frequent relapses and steroid dependence are common treatment challenges of steroid-sensitive nephrotic syndrome (SSNS) in children. Acute respiratory infection (ARI) is the most frequently reported trigger of relapse. Given the role of zinc supplementation in preventing ARI, some studies show that this targeted intervention may reduce relapses in childhood SSNS. Aim This systematic review aimed to determine if oral zinc supplementation can significantly reduce relapses in this disease. Methods We searched the PubMed and Google Scholar electronic databases for interventional and observational analytical studies without limiting their year or language of publication. We selected studies with primary data that met our inclusion criteria, screened their titles and abstracts, and removed duplicates. We used a preconceived structured form to extract data items from selected studies and conducted a quality assessment of randomized controlled trials (RCTs) and non-randomized studies with the Cochrane collaboration tool and the Newcastle Ottawa Scale, respectively. We qualitatively synthesized the extracted data to validate the review’s objective. Results Eight full-text articles were selected, comprising four RCTs and four observational analytical studies. Two of the RCTs had a high risk of bias in three parameters of the Cochrane collaboration tool, while three non-randomized studies had low methodological quality. A total of 621 pediatric patients with SSNS were investigated in the eight studies: six participants dropped out in one study. Three RCTs indicate that zinc supplementation may lead to sustained remission or reduction in relapse rate. Similarly, three observational analytical studies suggest a significant relationship between reduced serum zinc levels and disease severity. Conclusion Despite the association of zinc deficiency with increased morbidity in SSNS and the reduction of relapse rates with zinc supplementation, there is no robust evidence to recommend its use as a therapeutic adjunct. We recommend more adequately-powered RCTs to strengthen the current evidence.

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