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Steroids in the treatment of IgA nephropathy to the improvement of renal survival: a systematic review and meta-analysis Zhou YH; Tang LG; Guo SL; Jin ZC; Wu MJ; Zang JJ; Xu JF; Wu CF; Qin YY; Cai Q; Gao QB; Zhang SS; Yu DH; He JPLoS One 2011[Apr]; 6 (4): e18788BACKGROUND: 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 = -0.47 g/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.|Adrenal Cortex Hormones/*therapeutic use[MESH]|Creatinine/blood[MESH]|Glomerulonephritis, IGA/*drug therapy/physiopathology[MESH]|Humans[MESH]|Kidney Function Tests[MESH]|Proteinuria[MESH] |
