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Abstract: TH-PO619

Long-Term Renal Survival in Patients with IgA Nephropathy: A Systematic Review and Meta-Analysis

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Zhang, Huijian, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, Sichuan, China
  • Li, Guisen, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, Sichuan, China
Background

IgA nephropathy (IgAN), a primary glomerular disease named more than 50 years ago, is still one of the main causes of end-stage renal disease (ESRD) worldwide. Patients with ESRD incurred higher yearly costs and bear great financial pressure. Assessment of trends in renal survival could indicate whether changes in treatment strategies have resulted in improved long-term renal outcomes.

Methods

We searched the PubMed, Embase and Cochrane Database for cohort studies and clinical trials on renal survival with IgAN from their inceptions to November 2021. The outcome was defined as a composite of any of the following: doubling of serum creatinine level, 50% decline in estimated GFR (eGFR), or end-stage renal disease (ESRD). We extracted data on 3-year, 5-year, and 10-year renal survival in IgAN. Besides, we separately analyzed studies from developed countries and developing countries. We also analyzed the effect of proteinuria on long-term renal survival.

Results

We included 146 articles that reported on 98,334 patients from 1988 to 2021. The 3-year, 5-year and 10-year renal survival were 94.12% [95% confidence interval (CI) 94.08% to 94.16%], 88.64% (95% CI: 88.58% to 88.70%) and 77.46% (95% CI: 77.34% to 77.59%), respectively. In the past few decades, there have been no significant changes in 3-year and 5-year renal survival in IgAN patients. However, the 10-year renal survival of IgAN had gradually decreased since the late 1990s. Survival in developed countries was higher than in developing countries and fluctuate less. Furthermore, when proteinuria was < 1.0 g/24h, renal survival was improved.

Conclusion

We found that long-term renal survival was not increased over the years in IgAN. And the renal survival was lower in developing countries than in developed countries. The proteinuria was crucial in long-term prognosis of IgAN. When proteinuria was < 1g/24h, long-term renal survival was significantly improved. These results could be used to counsel patients on long-term renal survival and know the trend of survival in developed and developing countries.

Funding

  • Government Support – Non-U.S.