Estimation of childhood nephrotic syndrome incidence: data from the atlanta metropolitan statistical area and meta-analysis of worldwide cases

• Type of Material: Article
• Authors: Jackson Londeree, Emory University; Courtney E McCracken, Childrens Healthcare Atlanta; Larry Greenbaum, Emory University; Evan Anderson, Emory University; Laura Plantinga, Emory University; Scott E Gillespie, Childrens Healthcare Atlanta; Chia-Shi Wang, Emory University
• Language: English
• Date: 2021-07-02
• Publisher: SPRINGER HEIDELBERG
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021, Italian Society of Nephrology
• Final Published Version (URL): http://dx.doi.org/10.1007/s40620-021-01108-9
• Title of Journal or Parent Work: JOURNAL OF NEPHROLOGY
• Volume: 35
• Issue: 2
• Start Page: 575
• End Page: 583
• Grant/Funding Information: CW is supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number K23DK118189. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Our institution did not have any role in the study design, data collection, analysis, interpretation of data, writing the report, and/or the decision to submit the report for publication.
• Keywords: FOCAL SEGMENTAL GLOMERULOSCLEROSIS; Nephrotic syndrome; HLA-DQA1; Epidemiology; DISEASE; Urology & Nephrology; EPIDEMIOLOGY; TRENDS; Incidence; CHILDREN; RISK LOCI; Science & Technology; Meta-analysis; Life Sciences & Biomedicine

Abstract

Background: Epidemiological data on childhood idiopathic nephrotic syndrome (INS) are limited. We estimated childhood INS incidence in a racially and ethnically diverse U.S. population and performed a meta-analysis of published reports to examine differences by race, ethnicity, and time. Methods: One hundred seventy-five children aged 1–17 years living in the Atlanta Metropolitan Statistical Area (MSA) between 2013 and 2018 were identified by retrospective chart review. Annual INS incidence was estimated by dividing cases by population data from the Georgia Department of Public Health. We calculated pooled incidence estimates using random-effects regression models in a meta-analysis of the current and prior studies. Subgroup incidence estimates by race, ethnicity, and time were compared and tested for heterogeneity. Results: One hundred seventy-five children aged 1–17 were diagnosed with INS between 2013 and 2018 in the Atlanta MSA. Average annual incidence was 2.13/100,000 (95% CI, 1.83–2.47). Twenty-four studies were included in meta-analysis. Our study was the only one to report incidence for Hispanic children, 2.13/100,000/y (95% CI, 1.40–3.10). In meta-analysis, incidence was highest in Asian children (7.14/ 100,000/y; 95% CI, 4.73–9.54), followed by Black (3.53/100,000/y; 95% CI, 2.93–4.12), and Caucasian (1.83/100,000/y; 95% CI, 1.52–2.14). Annual incidence in the U.S. was stable comparing studies performed before and after 1984, 2.05 vs. 2.26/100,000 (p 0.08). Conclusions: Risk of INS may be higher among Asian and Black children compared to White children. Incidence appears stable over time in the U.S. Future studies should use standardized methodology and assess the contribution of demographic and genetic factors to INS incidence and long-term outcomes. Graphic abstract: [Figure not available: see fulltext.]