Galectin-3 in Cardiorenal Syndrome: A Systematic Review and Meta-analysis.

BACKGROUND: Galectin-3 (Gal-3) regulates cell adhesion, apoptosis, inflammation, and immune activation. Recent studies on Gal-3 and renocardiac or cardiorenal syndrome (CRS) show conflicting results. This meta-analysis systematically evaluated Gal-3 in predicting CRS subtypes and mortality. METHODS: We searched PubMed, EMBASE, The Cochrane Library, Web of Science, and the China National Knowledge Infrastructure (CNKI) for papers investigating the relationship between serum Gal-3 levels and CRS, from database inception to July 10, 2025, with an updated search conducted on March 1, 2026. Observational studies evaluating Gal-3 in relation to CRS incidence and mortality, heart failure (HF) mortality, and chronic kidney disease (CKD) mortality were included. RESULTS: A total of 281 articles were retrieved, and 22 were ultimately included after screening. High Gal-3 levels significantly predicted incident HF in CKD patients (hazard ratios [HR]: 1.19; 95% confidence interval [CI]: 1.10-1.28; P<0.0001) and predicted all-cause mortality in CKD patients (HR: 2.45; 95% CI: 1.37-4.37; P=0.002). In HF patients, Elevated Gal-3 levels were associated with a higher risk of the occurrence of CRS (odds ratios [OR]: 1.12; 95% CI: 1.03-1.22; P=0.01) and also predicted all-cause mortality (HR: 1.55; 95% CI: 1.33-1.82; P<0.00001). Finally, the 2 included studies indicated that Gal-3 was significantly associated with all-cause mortality in CRS patients. CONCLUSIONS: Gal-3 may serve as a significant predictor for the incidence of Type 2 and Type 4 CRS, the risk of mortality in HF and CKD patients, and all-cause mortality in CRS patients.