Renal Department, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Ren Fail. 2024 Dec;46(2):2394636. doi: 10.1080/0886022X.2024.2394636. Epub 2024 Aug 27.
The management strategy for IgA nephropathy (IgAN), has undergone constant improvements since the disease entity was first described 50 years ago. However, it is still unknown how these changes affected the long-term renal survival of IgAN patients. We systematically evaluate changes in IgAN renal survival by searching PubMed, Embase, and the Cochrane Library Database of Systematic Reviews from inception to 19 May 2024. We included a large sample of 103076 IgAN cases from 158 studies. Renal survival rates were 94.16% (95% CI: 94.02% to 94.31%), 88.68% (95% CI: 88.48% to 88.87%), and 78.13% (95% CI: 77.82% to 78.43%) at three, five, and ten-year, respectively. Over the past few decades, there haven't been any sound changes in the 3-year and 5-year renal survival rates. The kidney survival rate in developed countries is higher than in developing countries. Researchers consistently show that while proteinuria < 1.0 g/24 h, renal survival rates increase dramatically. In IgAN, long-term renal survival fluctuated rather than continuously improving over time. Our system review's findings indicate that supportive care-the most important recommendation for managing IgAN has shown promising results. The long-term outcomes of IgAN could be significantly improved by the latest developed treatment options.
IgA 肾病（IgAN）的管理策略自 50 年前首次描述以来，一直在不断改进。然而，目前仍不清楚这些变化如何影响 IgAN 患者的长期肾脏存活率。我们通过检索 PubMed、Embase 和 Cochrane 系统评价数据库，从建库至 2024 年 5 月 19 日，系统性评估了 IgAN 肾脏存活率的变化。我们纳入了来自 158 项研究的 103076 例 IgAN 大样本。肾脏存活率分别为 94.16%（95%CI：94.02%94.31%）、88.68%（95%CI：88.48%88.87%）和 78.13%（95%CI：77.82%~78.43%），分别在 3 年、5 年和 10 年时。在过去几十年中，3 年和 5 年的肾脏存活率没有明显变化。发达国家的肾脏存活率高于发展中国家。研究人员一致表明，当蛋白尿<1.0 g/24 h 时，肾脏存活率会显著增加。在 IgAN 中，长期肾脏存活率随时间波动，而不是持续改善。我们的系统评价结果表明，支持性治疗——管理 IgAN 的最重要建议，已经显示出了良好的效果。最新开发的治疗方案可能会显著改善 IgAN 的长期预后。
