Protocol for a systematic review of the application of the kidney failure risk equation and Oxford classification in estimating prognosis in IgA nephropathy.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101580575 Publication Model: Electronic Cited Medium: Internet ISSN: 2046-4053 (Electronic) Linking ISSN: 20464053 NLM ISO Abbreviation: Syst Rev Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central
    • Subject Terms:
      Glomerulonephritis, IGA*/classification ; Glomerulonephritis, IGA*/complications ; Glomerulonephritis, IGA*/pathology ; Systematic Reviews as Topic* ; Disease Progression* ; Kidney Failure, Chronic*; Humans ; Prognosis ; Risk Assessment/methods ; Renal Insufficiency, Chronic/classification ; Renal Insufficiency, Chronic/complications ; Biopsy
    • Abstract:
      Background: IgA nephropathy (IgAN) is a common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Outcomes are highly variable and predicting risk of disease progression at an individual level is challenging. Accurate risk stratification is important to identify individuals most likely to benefit from treatment. The Kidney Failure Risk Equation (KFRE) has been extensively validated in CKD populations and predicts the risk of ESRD at 2 and 5 years using non-invasive tests; however, its predictive performance in IgAN is unknown. The Oxford classification (OC) describes pathological features demonstrated on renal biopsy that are associated with adverse clinical outcomes that may also inform prognosis. The objective of this systematic review is to compare the KFRE with the OC in determining prognosis in IgAN.
      Methods: A systematic review will be conducted and reported in line with PRISMA guidelines (PRISMA-P checklist attached as Additional file 1). Inclusion criteria will be cohort studies that apply the KFRE or OC to determine the risk of CKD progression or ESRD in individuals with IgAN. Multiple databases will be searched in duplicate to identify relevant studies, which will be screened first by title, then by abstract and then by full-text analysis. Results will be collated for comparison. Risk of bias and confidence assessments will be conducted independently by two reviewers, with a third reviewer available if required.
      Discussion: Identifying individuals at the highest risk of progression to ESRD is challenging in IgAN, due to the heterogeneity of clinical outcomes. Risk prediction tools have been developed to guide clinicians; however, it is imperative that these aids are accurate and reproducible. The OC is based on observations made by specialist renal pathologists and may be open to observer bias, therefore the utility of prediction models incorporating this classification may be diminished, particularly as in the future novel biomarkers may be incorporated into clinical practice.
      Systematic Review Registration: PROSPERO CRD42022364569.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Chronic kidney disease; Disease progression; End-stage renal disease; Glomerulonephritis; IgA nephropathy; Kidney Failure Risk Equation; Kidney failure; Oxford classification; Prediction tool; Renal biopsy
    • Publication Date:
      Date Created: 20240504 Date Completed: 20240504 Latest Revision: 20240524
    • Publication Date:
      20240525
    • Accession Number:
      PMC11070080
    • Accession Number:
      10.1186/s13643-024-02543-y
    • Accession Number:
      38704598