Aging Promotes Progression of IgA Nephropathy: A Systematic Review and Meta-Analysis

Abstract

Background: There has been considerable interest in whether old age is associated with IgA nephropathy (IgAN) progression, which is still controversial. Methods: We searched multiple databases for studies published from 1980 to 2012. The inclusion criteria were case-control, cohort studies published in any language. The included studies needed to have an older group. IgAN was proven by biopsy. Results: We included 9 studies with a total of 6,543 patients. The meta-analyses of other risk factors between the older group (>50 years old) and the non-older group (15-50 years old) found significant differences in the presence of hypertension, proteinuria, serum cholesterol levels and baseline renal function. In the overall analysis, compared to the non-older group, older age significantly increased the incidence of developing end-stage renal disease [ESRD; relative risk (RR) random model 1.95; 95% CI: 1.27-3.01]. In the subgroup analyses, we found the age limit and traditional risk factors of IgAN may be the sources of heterogeneity between studies. Moreover, the RR (2.56) of the Asian countries was much higher than the RR (1.11) of the European countries. Conclusions: This comprehensive review revealed that old age is a real risk factor for IgAN progression to ESRD. The incidence of ESRD in the older IgAN patients was 1.95 times higher than that in the non-older IgAN patients. Moreover, the risk of IgAN progression to ESRD of the older patients in Asia was higher than that of the older patients in Europe.

Clinicopathologic Features of IgA-Dominant Infection-Associated Glomerulonephritis: A Pooled Analysis of 78 Cases

“…Meanwhile, old age is a risk factor for IgA-dominant IAGN as well as IgAN [42]. Therefore, it is possible that some of these cases are misdiagnosed as idiopathic IgAN.…”

Long-Term Outcome of IgA Nephropathy Patients with Recurrent Macroscopic Hematuria

“…A number of clinical features associated with the long-term outcome of patients with IgAN were identified in previous studies. These features include renal function, hypertension, proteinuria, hypoproteinemia, hyperuricemia, family history of renal disease, and episodes of macroscopic hematuria (MH) [1,2,3,4,5,6,7,8,9,10]. In addition, the new Oxford classification identified four definitive histological features for the prediction of the renal prognosis of IgAN [11,12,13,14].…”

Decreased expression of follicular dendritic cell–secreted protein correlates with increased immunoglobulin A production in the tonsils of individuals with immunoglobulin A nephropathy

“…[15][16][17] IgAN usually has a poor prognosis, with about 50% of patients progressing to end-stage renal disease within 30 years despite treatment. 18 Mesangial deposition of IgA has been considered to be the initiating event in the pathogenesis of IgAN; however, the origin of the increased IgA remains unclear.…”