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

摘要

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.