Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Transpl Immunol. 2023 Oct;80:101878. doi: 10.1016/j.trim.2023.101878. Epub 2023 Jun 20.
Recurrent IgA nephropathy (rIgAN) is an important cause of kidney allograft loss. Till now, no proven strategies have been confirmed to prevent/decrease the rIgAN. Here, a systematic review and meta-analysis were performed on the available interventions impacting rIgAN. PubMed, Embase, Web of sciences, ProQuest, and Cochrane library databases along with Google Scholar were searched for articles evaluating the rIgAN after kidney transplantation (up to 23 February 2023). The main inclusion criteria were kidney transplantation because of primary IgAN and articles studying the rate of the rIgAN based on different therapeutic interventions to find their effects on the disease recurrence. Based on our criteria, 11 papers were included in this systematic review, two of which pleased the criteria for the meta-analysis. Meta-analysis showed that the risk of the rIgAN in the steroid-free group was 3.33 times more than that of the steroid-receiving group (Pooled Hazard Ratio = 3.33, 95% CI 0.60 to18.33, Z-value = 1.38, p-value = 0.16). Steroid-free therapy increases the risk of rIgAN in kidney transplant recipients with primary IgAN. High-quality trials with large sample sizes studies are needed to confirm the impact of the steroids on decreasing the rate of the rIgAN.
复发性 IgA 肾病（rIgAN）是导致肾移植失败的重要原因。迄今为止，尚无经证实的策略可预防/减少 rIgAN。本研究对影响 rIgAN 的现有干预措施进行了系统评价和荟萃分析。检索了 PubMed、Embase、Web of sciences、ProQuest 和 Cochrane library 数据库以及 Google Scholar，以评估肾移植后 rIgAN 的相关文章（截至 2023 年 2 月 23 日）。主要纳入标准为因原发性 IgAN 而进行的肾移植，以及基于不同治疗干预措施研究 rIgAN 发生率的文章，以评估这些干预措施对疾病复发的影响。根据我们的标准，本系统评价共纳入 11 篇文章，其中 2 篇符合荟萃分析的标准。荟萃分析显示，在无激素组中 rIgAN 的风险是激素组的 3.33 倍（合并风险比=3.33，95%置信区间 0.60 至 18.33，Z 值=1.38，p 值=0.16）。无激素治疗会增加原发性 IgAN 肾移植受者发生 rIgAN 的风险。需要高质量、大样本量的试验来进一步证实激素对降低 rIgAN 发生率的影响。
