Evidence map›Paper›PMID 41385286›Full record

SynthesisClinical journal of the American Society of Nephrology : CJASN2026

The Association between Low-Grade Proteinuria and Adverse Kidney Outcomes in IgA Nephropathy: A Systematic Review and Meta-Analysis.

Yuya Yamaguchi, Takaaki Kosugi, Takaya Sasaki, Kotaro Haruhara, Yusuke Okabayashi, Masahiro Okabe, Akihiro Shimizu, Shinya Yokote, Sradha Kotwal, Min Jun and 5 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. When "Low-Grade" Is No Longer Low Risk in IgA Nephropathy.Clinical journal of the American Society of Nephrology : CJASN · 2026
    Article
  3. 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

15 authors.

Yuya YamaguchiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0009-0006-7941-5963
Takaaki KosugiDepartment of Nephrology, Nara Medical University, Nara, Japan.ORCID 0000-0003-3696-2263
Takaya SasakiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0001-9525-2638
Kotaro HaruharaDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0003-1918-0390
Yusuke OkabayashiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0001-7150-6947
Masahiro OkabeDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0002-0059-3542
Akihiro ShimizuDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0009-0009-5234-4845
Shinya YokoteDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0002-0252-4313
Sradha KotwalRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-3294-4087
Min JunRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0003-1460-7535
Brendon L NeuenRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0001-9276-8380
Kazuhiko TsuruyaDepartment of Nephrology, Nara Medical University, Nara, Japan.ORCID 0000-0002-8390-2928
Hiroyuki UedaDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0002-3938-2208
Nobuo TsuboiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0002-5407-5265
Takashi YokooDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0003-1838-7998

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

key pointsSystematic review/meta-analysis of 23 studies (15,289 patients) quantified prognostic effect of low-grade proteinuria in IgA nephropathy. Low-grade proteinuria (0.5-1.0 g/d) linked to higher kidney risk (hazard ratio, 1.73-2.87) and faster eGFR decline (-1.02 ml/min per year). Long-term suppression below 0.5 g/d should be a key therapeutic goal, supporting current IgA nephropathy clinical guidelines.

backgroundOvert proteinuria (>1.0 g/d) is a well-established risk factor for kidney disease progression in IgA nephropathy. However, recent evidence suggests that even low-grade proteinuria, typically defined as 0.5-1.0 g/d, may be clinically significant. The prognostic effect of low-grade proteinuria has not been systematically evaluated.

methodsWe conducted a systematic review and meta-analysis to evaluate the association between low-grade proteinuria and adverse kidney outcomes in patients with IgA nephropathy. A systematic literature search was performed on PubMed and Web of Science. Eligible studies included those reporting on kidney outcomes such as eGFR decline, kidney failure, or eGFR slope in relation to low-grade proteinuria measured either at baseline or during follow-up ( e.g ., time-averaged proteinuria). Data were synthesized using random-effects meta-analysis. The protocol was registered in the Open Science Framework REGISTRIES ( https://osf.io/5dfqr ).

resultsA total of 23 studies ( N =15,289) met the inclusion criteria, of which 15 contributed to at least one meta-analysis. Baseline low-grade proteinuria was significantly associated with an increased risk of adverse kidney outcomes compared with proteinuria below 0.5 g/d (pooled hazard ratio, 1.73; 95% confidence interval [CI], 1.36 to 2.20; nine studies). Similarly, low-grade time-averaged proteinuria was associated with a higher risk of kidney outcomes (pooled hazard ratio, 2.87; 95% CI, 1.48 to 5.56; seven studies) and a significantly steeper annual decline in eGFR (mean difference, -1.02 ml/min per 1.73 m 2 per year; 95% CI, -1.60 to -0.45; four studies). Subgroup analyses and leave-one-out sensitivity analyses were consistent with the overall findings.

conclusionsLow-grade proteinuria, whether assessed at baseline or over time, is an important predictor of kidney disease progression in patients with IgA nephropathy. These results reinforce recent clinical guidelines recommending proteinuria control under 0.5 g/d. Long-term suppression of proteinuria should be considered a key therapeutic goal in IgA nephropathy.

Indexed as

Glomerulonephritis, IGAProteinuriaDisease ProgressionGlomerular Filtration RateHumansKidneyPrognosisRisk FactorsalbuminuriaIgA nephropathyproteinuria

Identifiers

PMID41385286
PMCPMC13065120

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.