Prognostic Value of Elevated Plasma Galectin-3 for Renal Adverse Events in Dialysis Patients: A Systematic Review and Meta-Analysis

Context center dot In prognostic research, Galectin-3 (Gal-3) has gained recognition in renal fibrosis and nephrosis for its characteristics of promoting inflammation and fibrosis. High levels of Gal-3 may function as a predictor of adverse outcomes for patients with end-stage renal disease (ESRD). Objective center dot The review intended to systematically examine the significance of Gal-3 in the forecast of adverse outcomes for dialysis patients, using a method of evidencebased medicine. Design center dot The research team performed a systematic narrative review and meta-analysis by searching the Excerpta Medica Database (EMBASE) and the PubMed, Cochrane, and Web of Science databases for pertinent studies published before June 1, 2022. The search contained both meshes and free terms, such as Galectin 3, Gal-3, renal dialysis, hemodialysis, peritoneal dialysis, HD, and PD. Setting center dot The review took place at First People's Hospital of Linping District in Hangzhou, China. Outcome Measures center dot The research team used the Newcastle-Ottawa Scale (NOS) for assessment of the quality of the included research. The team created two reports to assess the value of Gal-3 in prediction of risk: (1) one for studies using continuous variables and (2) one for studies using categorical variables, dividing patients into high- and low-level Gal-3 groups with a cut-off value of Gal-3, being Gal-3 < 10.5 ng/mL for the lower tertile, and Gal-3 >= 13.4 ng/mL for the higher tertile. The team performed the meta-analysis using Stata 15.0, analyzed publication bias using Egger's test and directly showed it in a funnel plot. Results center dot The search found 1061 publications, with eight studies with 5194 participants being included in the current review. For the continuous variables, Gal-3 was associated with all-cause risk of death-Hazard ratio (HR) 1.06, 95%CI 1.01-1.12, and P =.024-and cardiovascular (CV) events-HR 1.13, 95%CI 1.07-1.203, and P =.000, but no significant correlation existed between Gal-3 and risk of CV mortality-HR 1.07, 95%CI 0.99-1.16, and P =.091. For the categorical variables, a high level of Gal-3 was correlated with a high risk of dying, from all causes-HR 2.05, 95%CI 1.50-2.80, and P =.000. Conclusions center dot Clinicians can use Gal-3 as a standalone forecaster of all-cause mortality and CV events for hemodialysis patients because correlates with these outcomes. Further research is necessary to determine its predictive value for CV mortality. Investigators need to perform further research with a large sample size on the predictive value of Gal-3 for dialysis patients, particularly PD patients, from a variety of ethnic backgrounds to improve the precise treatment for high-risk patients.