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Detection of MicroRNA Expression in the Kidneys of Immunoglobulin A Nephropathic Mice
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Evaluation of crescent formation as a predictive marker in immunoglobulin A nephropathy: a systematic review and

Xue Shao1,2,3, Bingjue Li1,2,3, Luxi Cao1,2,3

  • 1Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Oncotarget
|May 21, 2017
PubMed

Insights

Crescent formation in immunoglobulin A nephropathy (IgAN) significantly predicts kidney failure. This meta-analysis confirms crescents as a crucial prognostic factor, potentially warranting inclusion in future IgAN classifications.

Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Background:

  • The 2009 Oxford Classification for IgA nephropathy (IgAN) includes four histological predictors: mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T).
  • The prognostic value of crescent formation in IgAN remains debated.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the association between crescent formation and kidney outcomes in IgAN patients.
  • To assess the clinical significance of crescents as a prognostic factor in IgAN.

Main Methods:

  • Systematic search of PubMed and EMBASE databases for studies published between January 2009 and July 2016.
  • Inclusion of 20 studies comprising 5,285 IgAN patients.
  • Pooled analysis of data to determine the association between crescents and renal prognosis.

Main Results:

  • Crescent lesions were significantly associated with kidney failure (HR, 1.93; P < 0.001).
  • Patients with crescents exhibited lower estimated glomerular filtration rate (eGFR) and higher proteinuria.
  • Crescents correlated with higher frequencies of M1, E1, S1, and T1/2 lesions and increased immunosuppressive therapy use.

Conclusions:

  • Crescent formation is an effective prognostic factor in IgAN, strongly linked to progression to kidney failure.
  • The findings support the consideration of crescent formation in future revisions of the Oxford Classification for IgAN.

Keywords:
Immunoglobulin A (IgA) nephropathycrescent lesionsmeta-analysisoxford classification

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