Risk factors for relapse of pediatric PNS based on oral health problems: a prediction model

Based on an oral health survey at primary nephrotic syndrome (PNS) onset, a prediction model was developed to evaluate the impact of oral health on PNS relapse by identifying risk factors. This retrospective study included 112 children aged 3–6 years with PNS receiving standardized treatment at Xi’an Children’s Hospital (2020–2024). Oral health assessments (dmft, periapical fistula, PLI, GI) and clinical data were analyzed. Logistic regression identified predictors of relapse over 2 years. The study population included 112 participants. Dental caries prevalence was 87.50% (mean dmft 6.34 ± 4.60), with periapical fistula observed in 13.39% of cases. Additionally, 75.89% exhibited a PLI > 1, 31.25% had a GI > 1, and 48.21% received oral treatment during the observation period. Independent predictors of PNS relapse included dmft (OR = 1.26, 95% CI 1.06–1.55, P = 0.014), time to initial remission (OR = 1.22, 95% CI 1.07–1.44, P = 0.008), ALB (OR = 0.49, 95% CI 0.32–0.67, P < 0.001), 24-hour urine protein (OR = 1.08, 95% CI 1.04–1.14, P = 0.001), and TC (OR = 1.84, 95% CI 1.12–3.47, P = 0.032). Oral health, particularly higher dmft, is significantly associated with PNS relapse, warranting further mechanistic investigation.