Prognostic value of vascular lesions in immunoglobulin a nephropathy: a meta-analysis.

PURPOSE: Immunoglobulin A nephropathy (IgAN) stands as the most frequently observed primary glomerular disease globally and a major contributor to end-stage renal disease (ESRD). The aim of this study is to investigate the prognostic value of vascular lesions in IgAN through meta-analysis.

METHODS

Four databases, comprising Embase, Cochrane Library, PubMed, and Web of Science, were comprehensively searched from the commencement of each database to November 8, 2025. The quality of all eligible studies was evaluated utilizing the Newcastle-Ottawa scale (NOS). Statistical analysis was implemented using Stata (version 18.0). The association between vascular lesions in IgAN and adverse kidney outcomes was assessed by pooling hazard ratios (HRs) along with their corresponding 95% confidence intervals (CIs).

RESULTS

Totally 16 studies from 6 countries, involving 8,862 patients, were included. Among patients with IgAN, arteriosclerotic lesions increased the risk of poor kidney outcomes (HR = 1.95; 95%CI: 1.47, 2.60; P < 0.001). Similarly, microangiopathy (MA) triggered an elevated risk of adverse kidney outcomes (HR = 1.98; 95%CI: 1.54, 2.56; P < 0.001). Vascular lesions significantly raised this risk (HR = 2.27; 95%CI: 1.78, 2.91; P < 0.001). After adjustment for confounders, HRs remained statistically significant, indicating that both MA and arterial lesions were associated with adverse outcomes in IgAN.

CONCLUSION

Individuals suffering from IgAN with vascular lesions, including arteriosclerotic lesions and/or microangiopathy, are confronted with a pronouncedly elevated risk of experiencing poor kidney outcomes. After adjusting for available confounding factors, vascular lesions are associated with adverse renal prognosis in patients with IgAN.

CLINIC TRIAL NUMBER: Not applicable.