Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies

Background Decreased serum hemoglobin (Hb) level is associated with Immunoglobulin A nephropathy (IgAN) progression. However, whether serum Hb level is an independent prognostic factor of IgAN remains controversial. Herein, we aimed to investigate the prognostic value of serum Hb level in IgAN.Metho...

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Main Authors: Kang Zhang, Meng-di Wang, Shang-shang Jiang, Long Tang, Yue-fen Wang, Yuan Meng, Zhen Cai, Xue-yan Sun, Fang-qiang Cui, Wen-jing Zhao
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2171885
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author Kang Zhang
Meng-di Wang
Shang-shang Jiang
Long Tang
Yue-fen Wang
Yuan Meng
Zhen Cai
Xue-yan Sun
Fang-qiang Cui
Wen-jing Zhao
author_facet Kang Zhang
Meng-di Wang
Shang-shang Jiang
Long Tang
Yue-fen Wang
Yuan Meng
Zhen Cai
Xue-yan Sun
Fang-qiang Cui
Wen-jing Zhao
author_sort Kang Zhang
collection DOAJ
description Background Decreased serum hemoglobin (Hb) level is associated with Immunoglobulin A nephropathy (IgAN) progression. However, whether serum Hb level is an independent prognostic factor of IgAN remains controversial. Herein, we aimed to investigate the prognostic value of serum Hb level in IgAN.Methods The Cochrane Library, Embase, PubMed and Open Grey databases were systematically searched and reviewed. Kidney disease progression of IgAN was defined as a doubling of serum creatinine (SCr), a 30% reduction in estimated glomerular filtration rate (eGFR), end-stage renal disease (ESRD), or death. We evaluated the hazard ratio (HR) between serum Hb level and the incidence of kidney disease progression in IgAN before and after adjusting for relevant covariates.Results We included nine studies with 10006 patients in the meta-analysis. As a continuous variable, we found that serum Hb was an independent prognostic factor of IgAN [unadjusted HR = 0.89, 95% confidence interval (CI) = 0.84–0.95, I2 = 98%; adjusted HR = 0.85, 95% CI = 0.79–0.91, I2 = 0%]. The sensitivity analysis confirmed the stability of these results. Consistently, as a dichotomous variable defined as the below/above cutoff for anemia, we observed a positive correlation between serum Hb and kidney disease progression in IgAN (unadjusted HR = 2.12, 95% CI = 1.44–3.12, I2 = 79%; adjusted HR = 1.65, 95% CI = 1.20–2.27, I2 = 0%).Conclusion Serum Hb level was independently correlated with the incidence of kidney disease progression in IgAN.
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spelling doaj-art-ae26e5f095d44c71b819a739e96ab0ea2025-08-20T02:28:50ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2171885Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studiesKang Zhang0Meng-di Wang1Shang-shang Jiang2Long Tang3Yue-fen Wang4Yuan Meng5Zhen Cai6Xue-yan Sun7Fang-qiang Cui8Wen-jing Zhao9Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaBackground Decreased serum hemoglobin (Hb) level is associated with Immunoglobulin A nephropathy (IgAN) progression. However, whether serum Hb level is an independent prognostic factor of IgAN remains controversial. Herein, we aimed to investigate the prognostic value of serum Hb level in IgAN.Methods The Cochrane Library, Embase, PubMed and Open Grey databases were systematically searched and reviewed. Kidney disease progression of IgAN was defined as a doubling of serum creatinine (SCr), a 30% reduction in estimated glomerular filtration rate (eGFR), end-stage renal disease (ESRD), or death. We evaluated the hazard ratio (HR) between serum Hb level and the incidence of kidney disease progression in IgAN before and after adjusting for relevant covariates.Results We included nine studies with 10006 patients in the meta-analysis. As a continuous variable, we found that serum Hb was an independent prognostic factor of IgAN [unadjusted HR = 0.89, 95% confidence interval (CI) = 0.84–0.95, I2 = 98%; adjusted HR = 0.85, 95% CI = 0.79–0.91, I2 = 0%]. The sensitivity analysis confirmed the stability of these results. Consistently, as a dichotomous variable defined as the below/above cutoff for anemia, we observed a positive correlation between serum Hb and kidney disease progression in IgAN (unadjusted HR = 2.12, 95% CI = 1.44–3.12, I2 = 79%; adjusted HR = 1.65, 95% CI = 1.20–2.27, I2 = 0%).Conclusion Serum Hb level was independently correlated with the incidence of kidney disease progression in IgAN.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2171885Immunoglobulin A nephropathyserum hemoglobin levelprognosis
spellingShingle Kang Zhang
Meng-di Wang
Shang-shang Jiang
Long Tang
Yue-fen Wang
Yuan Meng
Zhen Cai
Xue-yan Sun
Fang-qiang Cui
Wen-jing Zhao
Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies
Renal Failure
Immunoglobulin A nephropathy
serum hemoglobin level
prognosis
title Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies
title_full Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies
title_fullStr Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies
title_full_unstemmed Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies
title_short Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies
title_sort is serum hemoglobin level an independent prognostic factor for iga nephropathy a systematic review and meta analysis of observational cohort studies
topic Immunoglobulin A nephropathy
serum hemoglobin level
prognosis
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2171885
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