The Value Of SuPAR In The Diagnosis Of Focal Segmental Glomerulosclerosis:a Meta-analysis

PurposeThrough meta analysis of suPAR expression in different pathological types of renal diseases,the relationship between suPAR and various pathological types of renal diseases was preliminarily discussed,and the factors affecting suPAR expression were further discussed.MethodsThe Chinese journal full-text database,Chinese biomedical literature database,PubMed(MEDLINE),EMBASE and Cochrane Library were respectively searched by computer,and the published one-off literatures related to suPAR and kidney diseases of different pathological types since the establishment of the database were collected by contacting the author or through literature review.Two evaluators screened the original literatures according to the inclusion and exclusion criteria of literatures respectively,and extracted the relevant data.The literature quality was evaluated according to the evaluation criteria.After data aggregation,Meta analysis was performed on the original data with STATA 12.0 software,and the combined SMD value and 95%confidence interval(CI)were calculated;meanwhile,sensitivity analysis and publication bias detection were performed.Result(1)Through strict screening,9 clinical control studies were finally included,including 658 patients with FSGS,404 patients with MCD,612 patients with IgA nephropathy,225 patients with MN,and 136 patients in the control group.The results of Meta analysis showed that there was a significant difference in the expression of suPAR between FSGS and MCD(SMD=0.89,95%ci(0.10,1.69),Z=2.20,P=0.028).2.There was a significant difference in suPAR expression between the FSGS group and the IgA group(SMD=1.95,95%ci(0.92,2.98),Z=3.70,P=0.000).3.There was no significant difference in the expression of suPAR between FSGS group and MN group(SMD=0.26,95%ci(-0.77,1.26),Z=0.49,P=0.627).4.There was a significant difference in suPAR expression between the FSGS group and the control group(SMD=1.91,95%ci(0.91,2.91),Z=3.75,P=0.000).(2)in longitudinal comparison,there was no significant difference in the expression of suPAR between different genders in FSGS patients(SMD=-0.08,95%ci(-0.43,0.27),Z=0.43,P=0.667).There was no significant difference in the expression level of suPAR between nephrotic syndrome and non-nephrotic syndrome(SMD=-0.84,95%ci(-2.9,1.22),Z=0.80,P=0.426).SuPAR expression was significantly different between eGFR>60 mL/min/1.73 m2 and eGFR<60 mL/min/1.73 m2(SMD=-2.97,95%ci(-0.66,-0.29)Z=2.16,P=0.031).ConclusionsSuPAR is expressed differently in different pathological types of renal diseases,and its expression in FSGS is higher than that in other pathological types,but it cannot be used as a marker to distinguish FSGS from other renal pathological types,especially to distinguish FSGS from MN.In addition,the expression of suPAR in FSGS is correlated with multiple factors,but has no significant relationship with gender,and is not significantly correlated with clinical manifestations of nephrotic syndrome and non-nephrotic syndrome,but it is significantly negatively correlated with the level of eGFR.