Corticosteroid for IgA Nephropathy: Are They Really Therapeutic?

Lin, Yujia; Jia, Junya; Guo, Yipeng; He, Dandan; Zhang, Yaru; Wang, Fuzhen; Yan, Tiekun; Liu, Youxia; Lin, Shan
July 2018
American Journal of Nephrology;Jul2018, Vol. 47 Issue 6, p385
Academic Journal
journal article
Background: IgA nephropathy (IgAN) is a common chronic glomerular disease that, in most patients, slowly progresses to end-stage kidney disease. The therapy with corticosteroid in IgAN is still a worldwide problem that is confusing the clinicians.Methods: MEDLINE, EMBASE, the Cochrane Library, and article reference lists were searched for randomized controlled trials (RCTs) that compared corticosteroids with placebo and any other non-immunosuppressive agents in treating IgAN. Twelve RCTs involving 1,057 patients were included.Results: Overall, we found that steroids had statistically significant effects in preventing the decline in renal function (relative risk 0.42, 95% CI 0.25-0.71, p < 0.001) and reducing proteinuria (SMD: -0.58 g/day, 95% CI -0.80 to -0.36 g/day) in patients with IgAN. The association between glucocorticoid and risk of kidney outcome was not modified by steroids' type (prednisone or methylprednisone), dose (≤30 or > 30 mg/day), duration (≤8 or > 8 months), or serum creatinine (< 1.10 or ≥1.10 mg/dL). But steroids increased the risk of side effects such as gastrointestinal and endocrinium symptoms.Conclusion: This study provides the clear beneficial effects of the steroids therapy on the kidney function and proteinuria, although it should be used with caution.


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