Crescents in native kidney biopsies from patients with IgA nephropathy and the risk of recurrence after kidney transplantation: a retrospective cohort study, systematic literature review and meta-analysis of observational studies.

What was studied

IgA nephropathy (IgAN) carries a high risk of kidney failure. The authors call kidney transplantation the top treatment option when this occurs. IgAN can recur in the transplanted kidney. This may raise the risk of graft loss. Crescents in native IgAN are a negative sign for progression to kidney failure. The team asked if crescents in native biopsies raise the risk of graft recurrence. They studied patients from Lausanne University Hospital with transplants from 2003 to 2019. They also searched PMC, Web of Science, Cochrane CENTRAL, Embase and MEDLINE. The search ran from inception to November 2025. Data were pooled in a meta-analysis.

What they found

The Lausanne cohort had 63 patients with IgAN who had a kidney transplant. Crescents in native biopsies were not linked to recurrence in the graft. The meta-analysis added more cohorts. In all it covered 311 patients. The share with recurrent IgAN was 23. The share with crescents ranged from 12 to 62. The risk ratio was 1.53. The range was 0.40 to 5.90. The p value was .41. This confirmed no link between crescents and recurrence.

What it means for patients

The authors say crescents remain an unfavourable sign for progression of IgAN to kidney failure. This is especially so when many viable glomeruli have them. They say crescents may not be a risk factor for recurrence in the transplanted kidney.

Why it is not certain yet

The risk ratio had a wide range, from 0.40 to 5.90. The Lausanne cohort was a retrospective cohort. The meta-analysis used observational studies. A review can only be as good as the studies in it.

Source

Crescents in native kidney biopsies from patients with IgA nephropathy and the risk of recurrence after kidney transplantation: a retrospective cohort study, systematic literature review and meta-analysis of observational studies.

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