Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Ren Fail. 2022 Dec;44(1):70-80. doi: 10.1080/0886022X.2021.2019589.
Hyperuricemia has been reported to be correlated with IgA nephropathy (IgAN). However, whether hyperuricemia or elevated serum uric acid (SUA) is an independent prognostic factor of IgAN remains unknown. Therefore, this systematic review and meta-analysis evaluated the prognostic value of hyperuricemia and elevated SUA in IgAN.
Databases including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and Open Gray were reviewed systematically. The kidney failure events of IgAN were defined as a doubling of serum creatinine, halving of eGFR, end-stage renal disease (ESRD), or death. The risk ratio (RR) between hyperuricemia and IgAN-caused kidney failure was evaluated before and after adjustment for relevant covariates. The RR between elevated SUA and IgAN-caused kidney failure was evaluated after adjustment for relevant covariates.
A total of 11 548 patients from 14 studies were included in this meta-analysis. Hyperuricemia was found to be an independent prognostic factor of IgAN (unadjusted RR = 2.79, 95% CI = 1.93-4.03, for heterogeneity <0.00001, = 91%; adjusted RR = 2.12, 95% CI = 1.64-2.73, for heterogeneity = 0.86, = 0%). Subgroup and sensitivity analyses confirmed the stability of these results. Similarly, elevated SUA was positively correlated with kidney failure events of IgAN (adjusted RR = 1.25, 95% CI = 1.19-1.31, for heterogeneity = 0.6, = 0%).
Our meta-analysis showed that hyperuricemia and elevated SUA were both independently associated with an increased incidence of kidney failure events in IgAN patients.
高尿酸血症已被报道与 IgA 肾病（IgAN）相关。然而，高尿酸血症或血清尿酸升高（SUA）是否是 IgAN 的独立预后因素尚不清楚。因此，本系统评价和荟萃分析评估了高尿酸血症和升高的 SUA 在 IgAN 中的预后价值。
系统检索了 PubMed、EMBASE、Cochrane 中心对照试验注册库（CENTRAL）和 Open Gray 数据库。IgAN 的肾衰竭事件定义为血清肌酐翻倍、eGFR 减半、终末期肾病（ESRD）或死亡。在调整相关协变量后，评估高尿酸血症与 IgAN 引起的肾衰竭之间的风险比（RR）。在调整相关协变量后，评估升高的 SUA 与 IgAN 引起的肾衰竭之间的 RR。
本荟萃分析共纳入了来自 14 项研究的 11548 名患者。高尿酸血症是 IgAN 的独立预后因素（未调整 RR=2.79，95%CI=1.93-4.03，异质性<0.00001，=91%；调整 RR=2.12，95%CI=1.64-2.73，异质性=0.86，=0%）。亚组和敏感性分析证实了这些结果的稳定性。同样，升高的 SUA 与 IgAN 的肾衰竭事件呈正相关（调整 RR=1.25，95%CI=1.19-1.31，异质性=0.6，=0%）。
本荟萃分析表明，高尿酸血症和升高的 SUA 均与 IgAN 患者肾衰竭事件的发生率增加独立相关。
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