Evidence map›Paper›PMID 33561333›Full record

ArticleThe Korean journal of internal medicine2021

Reduction in proteinuria after immunosuppressive therapy and long-term kidney outcomes in patients with immunoglobulin A nephropathy.

Shin Chan Kang, Hyung Woo Kim, Tae Ik Chang, Ea Wha Kang, Beom Jin Lim, Jung Tak Park, Tae-Hyun Yoo, Hyeon Joo Jeong, Shin-Wook Kang, Seung Hyeok Han

Open access · goldAbstract read
In one paragraph

Article in The Korean journal of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 54% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
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 2 institutions in 1 country.

Shin Chan KangDepartment of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Hyung Woo KimDepartment of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Tae Ik ChangDivision of Nephrology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Ea Wha KangDivision of Nephrology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Beom Jin LimDepartment of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Jung Tak ParkDepartment of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Tae-Hyun YooDepartment of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Hyeon Joo JeongDepartment of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Shin-Wook KangDepartment of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Seung Hyeok HanDepartment of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Yonsei University · KRNational Health Insurance Service Ilsan Hospital · KR

Funding

Korea Centers for Disease Control and Prevention 2019ER690101
6 · The paper itself

Abstract

BACKGROUND/

aimsDespite controversy regarding the benefits of immunosuppressive therapy in immunoglobulin A nephropathy (IgAN), clinical outcomes may vary depending on the patient's responsiveness to this therapy. This study evaluated long-term kidney outcomes according to the extent of proteinuria reduction after immunosuppression in IgAN patients.

methodsAmong 927 patients with biopsy-proven IgAN, 127 patients underwent immunosuppression. Time-averaged urine protein-creatinine ratio before and within 1 year after start of immunosuppression were calculated, and responsiveness to immunosuppression was assessed as the reduction of proteinuria between the two periods. Patients were classified into tertiles according to the extent of proteinuria reduction. We compared the slopes of estimated glomerular filtration rate (eGFR) decline using a linear mixed model, and estimated hazard ratios (HRs) for disease progression (defined as development of a ≥ 30% decline in eGFR or end-stage renal disease) using a Cox proportional hazard model.

resultsMedian extent of proteinuria reduction was -2.1, -0.9, and -0.2 g/gCr in the first, second, and third tertiles, respectively. There were concomitant changes in the slopes of annual eGFR decline: -2.03, -2.44, and -4.62 mL/min/1.73 m2 among the first, second, and third tertiles, respectively. In multivariable Cox analysis, the HRs (95% confidence intervals) for disease progression were 0.30 (0.12 to 0.74) in the first tertile and 0.70 (0.34 to 1.45) in the second tertile compared with the thirdtertile.

conclusionThis study showed that greater proteinuria reduction after immunosuppression was associated with a lower risk of disease progression in patients with IgAN, suggesting that responsiveness to immunosuppression may be an important determinant of kidney outcomes.

Indexed as

Glomerulonephritis, IGAKidney Failure, ChronicDisease ProgressionGlomerular Filtration RateHumansImmunosuppression TherapyKidneyProteinuriaTreatment OutcomeImmunoglobulin A nephropathyImmunosuppressionProteinuria

Identifiers

PMID33561333
PMCPMC8435500
OpenAlexW3127678480

What OpenQuestion holds

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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.