Pulmonary Thromboembolism (PTE) and Nephrotic Syndrome: A Systematic Review and Meta-analysis of Prevalence

Background: The incidence of thromboembolic complications in nephrotic children varies between 2% to 5% with a higher incidence in nephrotic syndrome than steroid responsive NS. Thrombosis is probably less recognized or under-reported in children with nephrotic syndrome. Aim: This work aims to determine the prevalence of pulmonary thromboembolism (PTE) in nephrotic syndrome patients. Materials and Methods: Careful search was performed over multiple medical databases to locate Internal Medicine studies, which studied the outcome of pulmonary thromboembolism (PTE) in nephrotic syndrome patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on PTE prevalence as the main outcome. Results: 10 studies were identified involving 9926 patients. The meta-analysis process revealed that pulmonary thromboembolism (PTE prevalence) in nephrotic syndrome patients of 10.6% (p<0.0001). We also found a nonsignificant publication bias (8 studies of 10 under funnel plot), (p>0.05). Conclusion: To conclude, pulmonary thromboembolism is considered the third ranking cardiovascular disease. Pulmonary thromboembolism is difficult to detect as it is mainly asymptomatic, detected only as incidentally, and diagnosed only after many visits to physicians; or remain undiagnosed during a person's life. Similarly, the prevalence among young persons is poorly documented.