Anti-phospholipid antibodies nephropathy is associated with an increased risk of kidney failure: a systematic literature review and meta-analysis.

IF 3.9 2区 医学 Q1 UROLOGY & NEPHROLOGY
Clinical Kidney Journal Pub Date : 2024-10-07 eCollection Date: 2024-10-01 DOI:10.1093/ckj/sfae302
Ariela Hoxha, Marco Lovisotto, Nicola Perin, Federico Nalesso, Dorella Del Prete, Paolo Simioni
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引用次数: 0

Abstract

Background: Anti-phospholipid antibodies nephropathy (aPL-N) is a complex feature of anti-phospholipid syndrome due to microvascular lesions. Renal prognosis and predictors of outcome are not yet known.

Methods: We performed a systematic review of the literature (February 2006-January 2024) using the PubMed, Scopus, Cochrane Library and EMBASE databases. Two reviewers independently conducted literature screening and data extraction in a blinded, standardized manner. A random effects model was used to pool odds ratios (ORs) [with 95% confidence interval (CI)] for the primary analysis, the risk of kidney failure. Subgroup analyses were performed for clinical and laboratory features that predicted renal outcomes. Heterogeneity was assessed by I2.

Results: Six records involving 709 patients were included in the meta-analysis. Biopsy-proven aPL-N was found in 238/832 (28.6%) patients. Acute kidney injury (AKI) was present at diagnosis in 20/65 (30.8%), while 73/233 (31.3%) patients with aPL-N developed chronic kidney disease (CKD)/end-stage kidney disease (ESKD) at follow-up. aPL-N was associated with an increased risk of CKD/ESKD [OR 6.89 (95% CI 2.42-19.58)] and AKI [OR 2.97 (95% CI 1-4-6.29)]. Arterial hypertension and positivity for lupus anticoagulant, anti-cardiolipin antibodies and anti-β2 glycoprotein I antibodies were associated with an increased risk of developing aPL-N [OR 3.7 (95% CI 1.9-7.23), OR 4.01 (95% CI 1.88-8.53), OR 2.35 (95% CI 1.31-4.21) and OR 19.2 (95% CI 2.91-125.75), respectively].

Conclusion: aPL-N is associated with poor renal outcomes. High blood pressure and aPL positivity have been identified as predictors of adverse renal outcomes. This up-to-date knowledge on renal outcomes and predictors of renal outcomes in aPL-N enables a personalized follow-up and therapeutic approach.

抗磷脂抗体肾病与肾衰竭风险增加有关:系统文献综述和荟萃分析。
背景:抗磷脂抗体肾病(aPL-N)是由微血管病变引起的抗磷脂综合征的一个复杂特征。肾病的预后和预测因素尚不清楚:我们使用 PubMed、Scopus、Cochrane Library 和 EMBASE 数据库对文献进行了系统性综述(2006 年 2 月至 2024 年 1 月)。两名审稿人以盲法和标准化的方式独立进行了文献筛选和数据提取。在主要分析(肾衰竭风险)中,采用随机效应模型对几率比 (OR) [含 95% 置信区间 (CI)]进行汇总。针对可预测肾功能结果的临床和实验室特征进行了亚组分析。异质性通过 I2 进行评估:荟萃分析纳入了六项记录,涉及 709 名患者。238/832(28.6%)例患者经活检证实患有 aPL-N。20/65(30.8%)的患者在确诊时出现急性肾损伤(AKI),73/233(31.3%)的 aPL-N 患者在随访时发展为慢性肾病(CKD)/终末期肾病(ESKD)。aPL-N 与 CKD/ESKD [OR 6.89 (95% CI 2.42-19.58)]和 AKI [OR 2.97 (95% CI 1-4-6.29)]的风险增加有关。动脉高血压以及狼疮抗凝物、抗心磷脂抗体和抗β2糖蛋白I抗体阳性与发生aPL-N的风险增加有关[OR分别为3.7(95% CI 1.9-7.23)、OR 4.01(95% CI 1.88-8.53)、OR 2.35(95% CI 1.31-4.21)和OR 19.2(95% CI 2.91-125.75)]。高血压和 aPL 阳性已被确定为不良肾脏预后的预测因素。对 aPL-N 肾脏预后和肾脏预后预测因素的最新了解有助于采取个性化的随访和治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Kidney Journal
Clinical Kidney Journal Medicine-Transplantation
CiteScore
6.70
自引率
10.90%
发文量
242
审稿时长
8 weeks
期刊介绍: About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
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