Systematic review and meta-analysis of serum and urinary biomarkers for predicting IgA vasculitis nephritis (IgAVN) in paediatric patients, drawing from 129 studies (n=23,726) identified across PubMed, EMBASE, and Cochrane Library up to November 2024.
NLR was significantly higher in patients with nephritis (SMD 0.48; 95% CI 0.04–0.93), with a stronger effect in Turkish cohorts (SMD 0.86) but no effect in Chinese cohorts (SMD –0.02). PLR followed a similar population-dependent pattern. A positive FOBT was associated with roughly double the odds of kidney involvement (OR 2.04; 95% CI 1.05–3.96).
- Majority of included studies were retrospective, limiting causal inference. - Sensitivity and specificity data were rarely reported, preventing robust diagnostic accuracy analysis. - Substantial heterogeneity in nephritis definitions, measurement methods, and study populations across included studies.
No biomarker yet meets the bar for routine clinical use to predict IgAVN in children. NLR, PLR, and FOBT are the most promising candidates and should be prospectively validated in multicentre studies with standardised nephritis definitions before being adopted in practice.
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