Evidence map›Paper›PMID 37547537›Full record

ArticleKidney international reports2023

Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy.

Angel M Sevillano, Fernando Caravaca-Fontán, Lucia Cordero Garcia-Galan, Gema Fernandez-Juarez, Katia Lopez-Revuelta, Diomaris A Guzmán, Guillermo Martín-Reyes, Luis F Quintana, Lida M Rodas, Maria Dolores Sanchez de la Nieta and 20 more

Abstract read
In one paragraph

Article in Kidney international reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  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

30 authors.

Angel M SevillanoDepartment of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Fernando Caravaca-FontánDepartment of Nephrology, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain.
Lucia Cordero Garcia-GalanDepartment of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Gema Fernandez-JuarezDepartment of Nephrology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
Katia Lopez-RevueltaDepartment of Nephrology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
Diomaris A GuzmánDepartment of Nephrology, Hospital Regional Universitario de Málaga, Malaga, Spain.
Guillermo Martín-ReyesDepartment of Nephrology, Hospital Regional Universitario de Málaga, Malaga, Spain.
Luis F QuintanaDepartment of Nephrology, Hospital Clinic de Barcelona, Barcelona, Spain.
Lida M RodasDepartment of Nephrology, Hospital Clinic de Barcelona, Barcelona, Spain.
Maria Dolores Sanchez de la NietaDepartment of Nephrology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Cristina RabascoDepartment of Nephrology, Hospital Universitario Reina Sofia, Cordoba, Spain.
Mario EspinosaDepartment of Nephrology, Hospital Universitario Reina Sofia, Cordoba, Spain.
Monserrat Diaz-EncarnaciónDepartment of Nephrology, Fundación Puigvert, Barcelona, Spain.
Luz San MiguelDepartment of Nephrology, Fundación Puigvert, Barcelona, Spain.
Clara BarriosDepartment of Nephrology, Hospital del Mar, Barcelona, Spain.
Eva RodriguezDepartment of Nephrology, Hospital del Mar, Barcelona, Spain.
Patricia GarciaDepartment of Nephrology, Hospital Virgen de la Victoria, Malaga, Spain.
Alfonso ValeraDepartment of Nephrology, Hospital Virgen de la Victoria, Malaga, Spain.
Jessy-Korina PeñaDepartment of Nephrology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
Amir ShabakaDepartment of Nephrology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
Mercedes VeloDepartment of Nephrology, Hospital Clínico San Carlos, Madrid, Spain.
Milagros SierraDepartment of Nephrology, Hospital San Pedro, Logroño, Spain.
Fayna GonzalezDepartment of Nephrology, Hospital Universitario Dr. Negrin, Gran Canaria, Spain.
Maria José Fernandez-ReyesDepartment of Nephrology, Hospital General de Segovia, Segovia, Spain.
Manuel HerasDepartment of Nephrology, Hospital General de Segovia, Segovia, Spain.
Patricia DelgadoDepartment of Nephrology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Eduardo GutierrezDepartment of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Juan Antonio MorenoDepartment of Cell Biology, Physiology and Immunology, University of Cordoba, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), UGC Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.
Manuel PragaDepartment of Nephrology, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain.
Spanish Group for the Study of Glomerular Diseases (GLOSEN)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes. Methods: This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression. Results: The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events. Conclusions: Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications.

Indexed as

acute kidney injuryadverse eventsIgA nephropathyimmunosuppressionkidney failuremacroscopic hematuria

Identifiers

PMID37547537
PMCPMC10403672

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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.