Evidence map›Paper›PMID 39819700›Full record

SynthesisSystematic reviews2025

Systematic review of the application of the Kidney Failure Risk Equation and Oxford classification in estimating prognosis in IgA Nephropathy.

M P Toal, R Fergie, M P Quinn, C J Hill, C O'Neill, A P Maxwell

Abstract readSystematic Review
In one paragraph

Synthesis in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

M P ToalCentre for Public Health, Queen's University of Belfast, Belfast, BT12 6AB, Northern Ireland. mtoal11@qub.ac.uk.
R FergieCentre for Public Health, Queen's University of Belfast, Belfast, BT12 6AB, Northern Ireland.
M P QuinnCentre for Public Health, Queen's University of Belfast, Belfast, BT12 6AB, Northern Ireland.
C J HillRegional Nephrology and Transplant Unit, Belfast City Hospital, Lisburn Road, BT9 7BA, Belfast, Northern Ireland.
C O'NeillCentre for Public Health, Queen's University of Belfast, Belfast, BT12 6AB, Northern Ireland.
A P MaxwellCentre for Public Health, Queen's University of Belfast, Belfast, BT12 6AB, Northern Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world and is an important cause of chronic kidney disease (CKD) and kidney failure. Outcomes are heterogeneous, and accurate risk stratification is important to identify the highest risk individuals for treatment and to help prevent disease progression. The Oxford classification (OC) is an internationally adopted standard for renal biopsy reporting in IgAN, which measures the degree of histological abnormalities and predicts prognosis. The kidney failure risk equation (KFRE) was developed to predict kidney failure in all causes of CKD and has been shown to be highly accurate across diverse etiologies. This review aimed to compare the KFRE with formulae incorporating the OC in accurately determining the risk of kidney failure in IgAN.

methodsA systematic review was conducted in accordance with the Cochrane library guidelines and PRISMA statement for reporting of systematic reviews. Studies comparing the accuracy of the KFRE with the OC in predicting disease progression and kidney failure in IgAN were evaluated. The search strategy and analysis were performed independently by two reviewers. Studies that were eligible for inclusion compared the KFRE with any tool incorporating the OC in a cohort of individuals with IgAN. Eligible outcomes were reduction of estimated glomerular filtration rate (eGFR) or end-stage renal disease (ESRD), and prognostic tools were required to assess the accuracy of these formulae by discrimination and/or calibration.

resultsAfter searching several databases, only one study was eligible for inclusion in the review. This study of 2300 Chinese individuals with IgAN had a median follow-up of 2.5 years. Two-hundred eighty-eight individuals had a composite outcome of 50% decline in eGFR or ESRD, and 214 individuals developed ESRD. Both the KFRE and the IgAN Risk Prediction (IRP) tool (incorporating the OC) were highly accurate at predicting ESRD with a C-statistic of 0.90 and 0.91, respectively. Subgroup analysis demonstrated improved performance of IRP over KFRE in discrimination for individuals with preserved eGFR (> 60 ml/min/1.73 m

conclusionThere is currently insufficient evidence to compare the accuracy of the KFRE and OC in determining outcomes in IgAN. Further research is required in this field. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022364569.

Indexed as

Glomerulonephritis, IGAKidney Failure, ChronicRenal InsufficiencyDisease ProgressionGlomerular Filtration RateHumansPrognosisRisk Assessment

Identifiers

PMID39819700
PMCPMC11737263

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.