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March 25, 2026Kidney International ReportsOpen Access

WCN26-4629 Variability in Glomerular Area and Adverse Kidney Outcomes in IgA Nephropathy

Leo Nozaki Takaya Sasaki Nobuo Tsuboi Hirokazu Marumoto Yusuke Okabayashi Kotaro Haruhara Hiroyuki Ueda Keita Hirano Takashi Yokoo

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Key Points

To investigate the relationship between variability in glomerular area and adverse kidney outcomes in IgA nephropathy.
Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs).
Searched multiple databases including MEDLINE and EMBASE for relevant studies.
Evaluated primary outcomes such as all-cause mortality and cardiovascular events.
Assessed risk of bias using the Cochrane tool and certainty of evidence through the GRADE approach.
No significant difference in all-cause mortality or cardiovascular events between intervention and control groups.
Point estimates suggested a possible increase in cardiovascular risk after RASi discontinuation.
The evidence certainty was rated as very low due to risk of bias and clinical heterogeneity.

Implication

Systematic review finds no impact of RASi discontinuation on kidney outcomes in IgA nephropathy, suggesting caution in clinical practice.

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Cite This Study

Nozaki et al. (2026) studied this question.

synapsesocial.com/papers/69c76fff8bbfbc51511e068c https://doi.org/10.1016/j.ekir.2026.104788

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Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

1Discontinuation of Renin-Angiotensin System Inhibitors and Clinical Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trialmeta-analysis · 2025 · 1 citations
2Outcomes of discontinuing renin-angiotensin system inhibitors: a study protocol for conducting systematic review and meta-analysissystematic_review · 2023 · 2 citations
3Discontinuation versus continuation of renin–angiotensin system inhibitors in chronic kidney disease stage 3–5 patients: a systematic review and meta-analysis2025 · 5 citations
4Effect of Discontinuation of Renin Angiotensin-System Inhibitors in Patients With Advanced Chronic Kidney Disease: A Meta-Analysismeta-analysis · 2023 · 12 citations
5Discontinuation of RAS Inhibition After an Acute Decline in Estimated Glomerular Filtration RateCohort Study · 2026 · 2 citations

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CARDIOVASCULAR IMPACT OF DISCONTINUATION OF RENIN-ANGIOTENSIN SYSTEM INHIBITORS IN ADVANCED CHRONIC KIDNEY DISEASE2024
Impact of renin-angiotensin system inhibitors discontinuation in advanced chronic kidney disease: a target trial emulation2026

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