TITLE

Steroids in the Treatment of IgA Nephropathy to the Improvement of Renal Survival: A Systematic Review and Meta-Analysis

AUTHOR(S)
Yu-Hao Zhou; Li-Gong Tang; Shi-Lei Guo; Zhi-Chao Jin; Mei-Jing Wu; Jia-Jie Zang; Jin-Fang Xu; Chun-Fang Wu; Ying-Yi Qin; Qing Cai; Qing-Bin Gao; Shan-Shan Zhang; Dand-Hui Yu; Jia He
PUB. DATE
April 2011
SOURCE
PLoS Clinical Trials;Apr2011, Vol. 8 Issue 4, Special section p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Studies have shown that steroids can improve kidney survival and decrease the risk of proteinuria in patients with Immunoglobulin A nephropathy, but the overall benefit of steroids in the treatment of Immunoglobulin A nephropathy remains controversial. The aim of this study was to evaluate the benefits and risks of steroids for renal survival in adults with Immunoglobulin A nephropathy. Methodology and Principal Findings: We searched the Cochrane Renal Group Specialized Register, Cochrane Controlled Trial Registry, MEDLINE and EMBASE databases. All eligible studies were measuring at least one of the following outcomes: end-stage renal failure, doubling of serum creatinine and urinary protein excretion. Fifteen relevant trials (n = 1542) that met our inclusion criteria were identified. In a pooled analysis, steroid therapy was associated with statistically significant reduction of the risk in end-stage renal failure (RR: 0.46, 95% CI: 0.27 to 0.79), doubling of serum creatinine (RR = 0.34, 95%CI = 0.15 to 0.77) and reduced urinary protein excretion (MD =20.47g/day, 95%CI =20.64 to 20.31). Conclusions/Significance: We identified that steroid therapy was associated with a decrease of proteinuria and with a statistically significant reduction of the risk in end-stage renal failure. Moreover, subgroup analysis also suggested that long-term steroid therapy had a higher efficiency than standard and short term therapy.
ACCESSION #
60801414

 

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