Evidence map›Paper›PMID 22539830›Full record

SynthesisJournal of the American Society of Nephrology : JASN2012

Corticosteroid therapy in IgA nephropathy.

Jicheng Lv, Damin Xu, Vlado Perkovic, Xinxin Ma, David W Johnson, Mark Woodward, Adeera Levin, Hong Zhang, Haiyan Wang, TESTING Study Group

Abstract readComparative StudyMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Society of Nephrology : JASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 10 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 10 syntheses or guidelines pooled it, 190 citations in OpenAlex.

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  12. Effects of Two Immunosuppressive Treatment Protocols for IgA Nephropathy.Journal of the American Society of Nephrology : JASN · 2018
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27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 4 countries.

Jicheng LvRenal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, No. 8 Xishiku Street, Xicheng District, Beijing, China.
Damin Xu
Vlado Perkovic
Xinxin Ma
David W Johnson
Mark Woodward
Adeera Levin
Hong Zhang
Haiyan Wang
TESTING Study Group
Peking University · CNPeking University First Hospital · CNJohns Hopkins University · USThe George Institute for Global Health · AUThe University of Queensland · AUUniversity of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The benefits and risks of steroids for the treatment of IgA nephropathy remain uncertain. We systematically searched MEDLINE, EMBASE, and the Cochrane Library for randomized, controlled trials of corticosteroid therapy for IgA nephropathy published between 1966 and March 2011. We identified nine relevant trials that included 536 patients who had urinary protein excretion >1 g/d and normal renal function. Forty-six (8.6%) of these patients developed a kidney failure event, defined as doubling of the serum creatinine/halving of the GFR or ESRD. Overall, steroid therapy was associated with a lower risk for kidney failure (relative risk, 0.32 [95% confidence interval [CI], 0.15-0.67]; P=0.002) and a reduction in proteinuria (weighted mean difference, -0.46 g/d [95% CI, -0.63 to -0.29 g/d]), with no evidence of heterogeneity in these outcomes. Subgroup analysis suggested that the dose modifies the effect of steroids for renal protection (P for heterogeneity=0.030): Relatively high-dose and short-term therapy (prednisone >30 mg/d or high-dose pulse intravenous methylprednisolone with duration ≤1 year) produced significant renal protection, whereas low-dose, long-term steroid use did not. Steroid therapy was associated with a 55% higher risk for adverse events. The quality of included studies was low, however, limiting the generalizability of the results. In conclusion, steroids appear to provide renal protection in patients with IgA nephropathy but increase the risk for adverse events. Reliably defining the efficacy and safety of steroids in IgA nephropathy requires a high-quality trial with a large sample size.

Indexed as

Administration, OralAdrenal Cortex HormonesChinaDisease-Free SurvivalDose-Response Relationship, DrugDrug Administration ScheduleFemaleGlomerulonephritis, IGAHumansInfusions, IntravenousKidney Failure, ChronicKidney Function TestsMaleMethylprednisolonePrednisonePrognosisAdrenal Cortex HormonesMethylprednisolonePrednisone

Identifiers

PMID22539830
PMCPMC3358763
OpenAlexW2107238505

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.