Evidence map›Paper›PMID 36600250›Full record

Trial reportTrials2023

Randomized control trial of prednisolone and doxycycline in patients with acute interstitial nephritis of unknown aetiology.

Zeid Badurdeen, Neelakanthi Ratnatunga, Tilak Abeysekera, Abdul W M Wazil, Premil N Rajakrishna, Jalitha P Thinnarachchi, Dulani D Welagedera, Nadeeka Ratnayake, Adambarage P D Alwis, Hemalika Abeysundara and 3 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 23% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
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

13 authors at 3 institutions in 2 countries.

Zeid BadurdeenCentre for Education Research and Training On Kidney Diseases (CERTKiD), Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka. zeid1964@gmail.com.ORCID http://orcid.org/0000-0003-4087-1647
Neelakanthi RatnatungaDepartment of Pathology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
Tilak AbeysekeraRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Abdul W M WazilRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Premil N RajakrishnaRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Jalitha P ThinnarachchiRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Dulani D WelagederaRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Nadeeka RatnayakeRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Adambarage P D AlwisRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Hemalika AbeysundaraDepartment of Statistics and Computer Science, Faculty of Science, University of Peradeniya, Kandy, Sri Lanka.
Ranjith KumarasiriDepartment of Community Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
Richard TaylorSchool of Public Health and Community Medicine (SPHCM), Faculty of Medicine, University of New South Wales (UNSW), Kensington, Australia.
Nishantha NanayakkaraRenal Transplant and Dialysis Unit, Teaching Hospital, Kandy, Sri Lanka.
Teaching Hospital Kandy · LKUniversity of Peradeniya · LKUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients presenting with acute interstitial nephritis (AIN) of unknown aetiology, probably the earliest presentation of chronic kidney disease of unknown aetiology (CKDu), have been treated with oral prednisolone and doxycycline by physicians in Sri Lanka. This trial assessed the effectiveness of prednisolone and doxycycline based on eGFR changes at 6 months in patients with AIN of unknown aetiology.

methodA randomized clinical trial with a 2 × 2 factorial design for patients presenting with AIN of unknown aetiology (n = 59) was enacted to compare treatments with; A-prednisolone, B-doxycycline, C-both treatments together, and D-neither. The primary outcome was a recovery of patients' presenting renal function to eGFR categories: 61-90 ml/min/1.73m

resultsSeventy patients compatible with a clinical diagnosis of AIN were biopsied for eligibility; 59 AIN of unknown aetiology were enrolled, A = 15, B = 15, C = 14 and D = 15 randomly allocated to each group. Baseline characteristics were similar between groups. The number of patients with CR, PR and NR, respectively, by 6 months, in group A 3:8:2, group B 2:8:3 and group C 8:5:0 was compared with group D 8:6:1. There were no significant differences found between groups A vs. D (p = 0.2), B vs. D (p = 0.1) and C vs. D (p = 0.4). In an exploratory analysis, progression-free survival in prednisolone-treated (A + C) arms was 0/29 (100%) in comparison to 25/30 (83%) in those not so treated (B + D) arms, and the log-rank test was p = 0.02, whereas no such difference found (p = 0.60) between doxycycline-treated (B + C) arms 27/29 (93%) vs those not so treated (A + D) arms 27/30 (90%).

conclusionPrednisolone and doxycycline were not beneficial for the earliest presentation of CKDu at 6 months. However, there is a potential benefit of prednisolone on the long-term outcome of CKDu. An adequately powered steroid trial using patients reaching < 30 ml/min/1.73m

trial registrationSri Lanka Clinical Trial Registry SLCTR/2014/007, Registered on the 31st of March 2014.

Indexed as

DoxycyclineNephritis, InterstitialPrednisoloneRenal Insufficiency, ChronicGlucocorticoidsHumansSri LankaDoxycyclineGlucocorticoidsPrednisoloneAcute interstitial nephritisClinical trialDoxycyclinePrednisoloneUnknown aetiology

Identifiers

PMID36600250
OpenAlexW4313495411

What OpenQuestion holds

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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.