Steroids in the treatment of IgA nephropathy to the improvement of renal survival: a systematic review and meta-analysis.

<h4>Background</h4>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...

Full description

Saved in:
Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-04-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0018788&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:<h4>Background</h4>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.<h4>Methodology and principal findings</h4>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 = -0.47 g/day, 95%CI = -0.64 to -0.31).<h4>Conclusions/significance</h4>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.
ISSN:1932-6203