Steroids in the treatment of iga nephropathy to the improvement of renal survival: A systematic review and meta-analysis

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*

*Corresponding author for this work

Research output: Contribution to journalArticle

18 Scopus citations

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 = -0.47g/day, 95%CI = -0.64 to -0.31). 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.

Original languageEnglish (US)
Article numbere18788
JournalPloS one
Volume6
Issue number4
DOIs
StatePublished - 2011

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Zhou, Y. H., Tang, L. G., Guo, S. L., Jin, Z. C., Wu, M. J., Zang, J. J., Xu, J. F., Wu, C. F., Qin, Y. Y., Cai, Q., Gao, Q. B., Zhang, S. S., Yu, D. H., & He, J. (2011). Steroids in the treatment of iga nephropathy to the improvement of renal survival: A systematic review and meta-analysis. PloS one, 6(4), [e18788]. https://doi.org/10.1371/journal.pone.0018788