Evaluation of crescent formation as a predictive marker in immunoglobulin A nephropathy: a systematic review and meta-analysis

Oncotarget
Xue ShaoJianghua Chen

Abstract

The 2009 Oxford Classification of immunoglobulin A (IgA) nephropathy (IgAN) identifies four histological features as predictors of renal prognosis: mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T). However, the clinical and prognostic significance of crescent formation still remains controversial. Therefore, we performed a meta-analysis to evaluate the association between crescents and kidney outcome in IgAN. A total of 20 studies published from January 2009 to July 2016 involving 5,285 patients were included after systematic searches of PubMed and EMBASE databases. Pooled results showed that crescent lesions were associated with kidney failure (HR, 1.93; 95% CI, 1.49-2.50; P < 0.001). IgAN patients with crescents had lower eGFR levels (SMD, -0.21; 95% CI, -0.40--0.03; P = 0.023); higher proteinuria levels (SMD, 0.87; 95% CI, 0.11-1.63; P = 0.024); a larger number of patients with M1 (RR, 1.22; 95% CI, 1.07-1.40; P = 0.003), E1 (RR, 4.83; 95% CI, 3.04-7.66;P < 0.001), S1 (RR, 1.76; 95% CI, 1.11-2.80; P = 0.016) and T1/2 (RR, 2.74; 95% CI, 2.10-3.57; P < 0.001) lesions; and received immunosuppressive therapy more frequently (RD, 0....Continue Reading

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Citations

Feb 28, 2019·Clinical and Experimental Pharmacology & Physiology·Yingjie HanDavid J Nikolic-Paterson
Feb 1, 2019·Terapevticheskiĭ arkhiv·V A Dobronravov, A V Smirnov
Jul 12, 2019·Clinical and Experimental Medicine·Zheng-Xia ZhongWei Qin
Apr 28, 2021·International Urology and Nephrology·Xinyao LuoYahong Hu
Apr 17, 2020·Kidney & Blood Pressure Research·Precil Diego Miranda de Menezes NevesViktoria Woronik

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Methods Mentioned

BETA
biopsy

Software Mentioned

PRISMA
VALIGA
Stata

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