Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing, China.
Outpatient Department, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing, China.
Ren Fail. 2024 Dec;46(2):2411846. doi: 10.1080/0886022X.2024.2411846. Epub 2024 Oct 28.
The Oxford Classification was proposed as an independent prognostic indicator in IgA nephropathy (IgAN). However, most studies on the subject focus on adults instead of children.
Using a meta-analysis to appraise the predictive roles of the Oxford classification for the prognosis of pediatric patients with IgAN.
All cohort studies regarding the analysis of the association between poor kidney-related prognosis (GFR categories G2-G5) according to the Kidney Disease Improving Global Outcomes (KDIGO) Guideline in pediatric patients with IgAN and five pathologic lesions in the Oxford Classification were included. Hazard ratios (HRs) regarding the association between the Oxford classification and prognosis of pediatric patients with IgAN were synthesized using random effect models. The risk of bias in studies was assessed based on the Newcastle-Ottawa scale.
Fourteen articles were included with 5679 IgAN patients and 710 endpoint outcome events occurred. M1 was associated with a higher risk of poor kidney-related prognosis compared with M0, pooled HR (1.79; 95%CI, 1.46-2.19; < 0.001, random effect model). S1 and T1 or T2 increased the risk of poor kidney-related prognosis (pooled HR, 2.13; 95%CI, 1.68-2.70; < 0.001; pooled HR, 2.64; 95%CI, 1.81-3.86; < 0.001, respectively, estimated by random effect model). Compared with C0, C1, or C2 was also associated with an increased risk of poor kidney-related prognosis in the subgroup analysis of Asian and other populations. Evidence to indicate that E1 increased the risk of poor kidney-related prognosis was marginal.
牛津分类法被提出作为 IgA 肾病（IgAN）的独立预后指标。然而，大多数关于该主题的研究都集中在成年人，而不是儿童。
通过荟萃分析评估牛津分类法对儿童 IgAN 患者预后的预测作用。
纳入所有关于根据肾脏病改善全球结局（KDIGO）指南分析 IgAN 患儿不良肾脏相关预后（GFR 类别 G2-G5）与牛津分类法 5 种病理损伤之间关联的队列研究。使用随机效应模型综合牛津分类法与 IgAN 患儿预后之间的关联的危险比（HRs）。根据纽卡斯尔-渥太华量表评估研究的偏倚风险。
纳入 14 篇文章，共纳入 5679 例 IgAN 患者和 710 例终点结局事件。与 M0 相比，M1 与不良肾脏相关预后的风险增加相关，合并 HR（1.79；95%CI，1.46-2.19； < 0.001，随机效应模型）。S1 和 T1 或 T2 增加了不良肾脏相关预后的风险（合并 HR，2.13；95%CI，1.68-2.70； < 0.001；合并 HR，2.64；95%CI，1.81-3.86； < 0.001，分别由随机效应模型估计）。在亚洲和其他人群的亚组分析中，与 C0 相比，C1 或 C2 也与不良肾脏相关预后的风险增加相关。表明 E1 增加不良肾脏相关预后风险的证据尚属边缘。
