A Systematic Review on the Risk Factors of Steroid-Sensitive Nephrotic Syndrome Relapse in the Pediatric Population

Background: Identifying affecting and predictive factors of steroid-sensitive nephrotic syndrome’s (SSNS’s) outcome may greatly benefit the proper management of SSNS patients.  Objectives: The current systematic review comprehensively reviews all available evidence on the risk factors of SSNS relapse in children and adolescents.  Methods: An extensive search was conducted on the electronic databases of Medline, Embase, Web of Science, and Scopus until February 18, 2024. Studies investigating the risk factors of relapse were included in this systematic review. Results: A total of 11 articles were included. Age, gender, and laboratory variables, such as serum creatinine and serum protein are not risk factors for relapse in these studies. Possible associations were reported for risk factors, such as the number of relapses and response time. Overall, the studies reported conflicting results on the value of relapse risk factors. Conclusions: Although factors, such as hematuria, hypertension, time from treatment to response, and number of relapses have been proposed as possible risk factors for relapse, no conclusion can be reached due to the heterogeneity of studies. Future studies should have more conforming designs to make comparisons more reliable.