Epidemiology, clinical features, risk factors, and outcomes in anti-glomerular basement membrane disease: A systematic review and meta-analysis

IF 9.2 1区 医学 Q1 IMMUNOLOGY
Huang Kuang , Nan Jiang , Xiao-Yu Jia , Zhao Cui , Ming-Hui Zhao
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Abstract

Anti-glomerular basement membrane (GBM) disease is a small-vessel vasculitis that represents the most aggressive form of autoimmune glomerulonephritis. The study aimed to investigate the prevalence, clinical characteristics, risk factors, and outcomes of anti-GBM disease through a systematic review and meta-analysis involving 47 studies with 2830 patients. The overall incidence of anti-GBM disease ranged from 0.60 to 1.79 per million population per annum. In rapidly progressive glomerulonephritis and crescentic glomerulonephritis, the pooled incidence rates were 8.0% and 12.8%, respectively. The pooled prevalence rates of anti-GBM antibodies, antineutrophil cytoplasmic antibodies (ANCA), and lung hemorrhage were 88.8%, 27.4%, and 32.6%, respectively. Patients with combined ANCA positivity demonstrated a prognosis comparable to those patients with only anti-GBM antibodies, though with differing clinical features. The pooled one-year patient and kidney survival rates were 76.2% and 30.2%, respectively. Kidney function on diagnosis and normal glomeruli percentage were identified as strong prognostic factors. This study represents the first comprehensive meta-analysis on anti-GBM disease, providing insights into its management. However, caution is warranted in interpreting some results due to the observational nature of the included studies and high heterogeneity.

抗肾小球基底膜病的流行病学、临床特征、风险因素和预后:系统回顾与荟萃分析。
抗肾小球基底膜病(GBM)是一种小血管炎,是自身免疫性肾小球肾炎中最具侵袭性的一种。该研究旨在通过一项系统性回顾和荟萃分析,调查抗肾小球基底膜病的发病率、临床特征、风险因素和预后,共涉及 47 项研究,2830 名患者。抗 GBM 疾病的总体发病率为每年每百万人口 0.60 至 1.79 例。在快速进展性肾小球肾炎和新月体性肾小球肾炎中,汇总发病率分别为 8.0% 和 12.8%。抗 GBM 抗体、抗中性粒细胞胞浆抗体(ANCA)和肺出血的汇总发病率分别为 88.8%、27.4% 和 32.6%。合并 ANCA 阳性的患者的预后与仅有抗 GBM 抗体的患者相当,但临床特征有所不同。患者和肾脏的一年存活率分别为76.2%和30.2%。诊断时的肾功能和正常肾小球百分比被认为是强有力的预后因素。这项研究是首次对抗 GBM 疾病进行全面的荟萃分析,为其治疗提供了启示。然而,由于纳入研究的观察性质和高度异质性,在解释某些结果时需要谨慎。
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来源期刊
Autoimmunity reviews
Autoimmunity reviews 医学-免疫学
CiteScore
24.70
自引率
4.40%
发文量
164
审稿时长
21 days
期刊介绍: Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.
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