Evidence map›Paper›PMID 28926143›Full record

ArticleTransplant international : official journal of the European Society for Organ Transplantation2018

Recurrence of IgA nephropathy after kidney transplantation in steroid continuation versus early steroid-withdrawal regimens: a retrospective analysis of the UNOS/OPTN database.

Napat Leeaphorn, Neetika Garg, Eliyahu V Khankin, Francesca Cardarelli, Martha Pavlakis

Open access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplant international : official journal of the European Society for Organ Transplantation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
2.7field-weighted citation impact, top 9% 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

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.

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  18. Diabetes and Cardiovascular Risk in Renal Transplant Patients.International journal of molecular sciences · 2021
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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

5 authors at 1 institution in 1 country.

Napat LeeaphornTransplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.ORCID 0000-0003-3133-4479
Neetika GargTransplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Eliyahu V KhankinTransplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Francesca CardarelliTransplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Martha PavlakisTransplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Beth Israel Deaconess Medical Center · US

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
Preeclampsia and renal complications: late effects on kidney and vasculatureK08DK101560 · NIDDK · BETH ISRAEL DEACONESS MEDICAL CENTER · PI KHANKIN, ELIYAHU · 2014 to 2017
$616k
NCATS NIH HHS UL1 TR001102NIDDK NIH HHS K08 DK101560
6 · The paper itself

Abstract

In the past 20 years, there has been an increase in use of steroid-withdrawal regimens in kidney transplantation. However, steroid withdrawal may be associated with an increased risk of recurrent IgA nephropathy (IgAN). Using United Network of (Organ Sharing/Organ Procurement and Transplantation Network) UNOS/OPTN data, we analyzed adult patients with end-stage renal disease (ESRD) due to IgAN who received their first kidney transplant between 2000 and 2014. For the primary outcome, we used a competing risk analysis to compare the cumulative incidence of graft loss due to IgAN recurrence between early steroid-withdrawal (ESW) and steroid continuation groups. The secondary outcomes were patient survival and death-censored graft survival (DCGS). A total of 9690 recipients were included (2831 in ESW group and 6859 in steroid continuation group). In total, 1238 recipients experienced graft loss, of which 191 (15.43%) were due to IgAN recurrence. In multivariable analysis, steroid use was associated with a decreased risk of recurrence (subdistribution hazard ratio 0.666, 95% CI 0.482-0.921; P = 0.014). Patient survival and DCGS were not different between the two groups. In the USA, ESW in transplant for ESRD due to IgAN is associated with a higher risk of graft loss due to disease recurrence. Future prospective studies are warranted to further address which patients with IgAN would benefit from steroid continuation.

Indexed as

Withholding TreatmentAdrenal Cortex HormonesAdultAnalysis of VarianceCohort StudiesDatabases, FactualFemaleGlomerulonephritis, IGAGraft RejectionGraft SurvivalHumansKaplan-Meier EstimateKidney Failure, ChronicKidney TransplantationMaleMiddle AgedAdrenal Cortex HormonesIgA nephropathyimmunosuppressionsteroidstransplant outcomes

Identifiers

PMID28926143
PMCPMC5762402
OpenAlexW2755834104

What OpenQuestion holds

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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.