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2016 ; 95
(35
): e4731
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The effect of calcineurin inhibitors in the treatment of IgA nephropathy: A
systematic review and meta-analysis (PRISMA)
#MMPMID27583915
Peng W
; Tang Y
; Jiang Z
; Li Z
; Mi X
; Qin W
Medicine (Baltimore)
2016[Aug]; 95
(35
): e4731
PMID27583915
show ga
BACKGROUND: Immunoglobin A nephropathy (IgAN), the most prevalent form of primary
glomerulonephritis, represents the leading cause of kidney failure among East
Asian populations. Immunosuppressive treatment regimen, except for a 6-month
trial of corticosteroids, has not been approved by the KDIGO guideline yet.
Specific and effective treatment is still lacking. We decided to evaluate the
efficacy and safety of the calcineurin inhibitors (CNIs) in the treatment of
IgAN. METHODS: Database from the Cochrane library, PubMed, Embase, CBM, CNKI, and
CENTRAL databases were searched and reviewed up to March 2016. Literature was
screened by 2 independent reviewers accordingly. Clinical trials were analyzed
using Stata 12.0. RESULTS: Five random control trials and 2 nonrandomized
concurrent control trials were selected and included in this study according to
our inclusion and exclusion criteria. The rates of complete remission in patients
with IgAN were significantly increased in the group of CNIs (RR 1.56, P?=?0.002).
No statistical difference was observed in the rates of partial remission, or
response between the CNIs and steroids alone. Additionally, CNIs resulted in a
significant reduction in urinary protein (WMD 0.34, P?=?0.002) and increase in
serum albumin level (WMD 1.89, P?=?0.013). No differences were found in the serum
creatinine, estimated glomerular filtration rate, and rates of adverse effects
including infection, hyperglycemia, and liver dysfunction. CONCLUSION: With
present evidence, CNIs may be promising immunosuppressive agents for IgAN in
future. However, large, long-term, multicenter trials are required to confirm our
findings.
|Calcineurin Inhibitors/adverse effects/*therapeutic use
[MESH]