Table 1.
Characteristics of RCTs involved in the study
| Study | Patients | Kidney Functiona | Proteinuriaa | Sample Sizeb | Steroid Group | Control | Follow–up (mo) | Drop-in/Steroid Discontinuation | Events, n (%)c | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Dose | Duration of Steroid Therapy | ||||||||||
| Lai et al.,15 1986 (China) | IgA nephropathy with nephrotic syndrome | Scr: 1.36±0.59 mg/dl | 5.6±2.21 g/d | 34 (17/17) | Prednisone or prednisolone: initial dose, 40–60 mg/d, then tapered | 4 | No treatment | 38 | NA/0 | 0 | 0 |
| Julian and Barker,21 1993 (USA) | Ccr > 25 ml/min per 1.73 m2; proteinuria > 1 g/d or chronic lesions in renal specimen | Scr: 1.54±0.19 mg/dl | 3.35±0.6 g/d | 35 (17/18) | Prednisone: initial, 60 mg every other day for 3 mo, then tapered | 24 | No treatment | 6–24 | NA/2 | 1d (5.9) | 2d (11.1) |
| Shoji et al.,22 2000 (Japan) | Proteinuria < 1.5g/d; Scr < 1.5 mg/dl; mesangial cell proliferation or matrix accumulation involving >50% of glomeruli | Scr: 0.74±0.22 mg/dl | 0.75±0.31 mg/d | 19 (11/8) | Prednisolone: 0.8 mg/kg per day, then tapered; dipyridamole: 300 mg/dl | 12 | Dipyridamole, 300 mg/d | 12 | NA/0 | 0 | 0 |
| Katafuchi et al.,19 2003 (Japan) | Scr < 1.5 mg/dl; glomerular score: 4–7 | Scr: 0.91±0.22 mg/dl | UPC ratio: 1.63±1.53 | 90 (43/47) | Prednisolone: 20 mg/d, gradually tapered to 5 mg/d; dipyridamole: 150–300 mg/d | 24 | Dipyridamole, 150–300 mg/d | 65 | NA/1 | 3d (7.0) | 3d (6.4) |
| Pozzi et al.,24 2004 (Italy) | Scr < 1.5 mg/dl; proteinuria 1–3.5 g/d | Median Scr in steroid group: 1.10 mg/dl (IQR, 0.90–1.30); in control group: 0.98 mg/dl (IQR, 0.81–1.27) | Steroid group: median, 2.0 g/d (IQR, 1.6–2.4); control group: median, 1.8 mg/dl (IQR:1.4–2.4) | 86 (43/43) | Methylprednisolone: 1.0 g × 3 d; prednisone: 0.5 mg/kg every other day | 6 | Supportive therapy | 120 | 13/4 | 1e (2.3) | 13e (30.2) |
| Hogg et al.,18 2006 (USA) | UPC ratio > 1.0 or > 0.5 with renal pathologic lesions at risk; GFR > 50 ml/min per 1.73 m2 | Estimated GFR: 108.5±43.1 ml/min per 1.73 m2 | UPC ratio: 1.81±1.98 | 64 (33/31) | Prednisone: initial, 60 mg every other day for 3 mo, then tapered | 24 | Placebo | 24 | NA/NA | 2f (6.1) | 4f (12.9) |
| Koike et al.,16 2008 (Japan) | Mild inflammatory activities | Scr: 1.04±0.31 mg/dl | 0.93±0.63 g/d | 48 (24/24) | Prednisolone: 0.4 mg/kg per day, gradually tapered to 5–10 mg/d; | 24 | Dipyridamole or dilazep hydrochloride | 24 | NA/NA | NA | NA |
| dipyridamole or dilazep hydrochloride | |||||||||||
| Lv et al.,20 2009 (China) | Proteinuria 1–5 g/d; GFR > 30 ml/min per 1.73 m2 | Scr: 1.1±0.3 mg/dl | 2.26±0.85 g/d | 63 (33/30) | Prednisone: 0.8–1 mg/kg per day for 8 wk, then tapered; cilazapril | 6–8 | Cilazapril | 27.3 | 0/0 | 0 | 2d (6.7) |
| Manno et al.,17 2009 (Italy) | Proteinuria > 1 g/d; GFR > 50 ml/min per 1.73 m2; moderate renal lesions | Scr: 1.07±0.29 mg/dl | Steroid group: median, 1.7 g/d (IQR, 1.2–2.5); control group: median, 1.5 g/d (IQR, 1.4–2.3) | 97 (48/49) | Prednisone: initial, 1 mg/kg per day for 2 mo, then tapered; ramipril | 6 | Ramipril | 96 | 1/1 | 2e (4.2) | 13e (26.5) |
Drop in, patients who are randomized to standard/control arm but start taking/using the experimental treatment; Scr, serum creatinine; NA, not available; Ccr, creatine clearance; UPC, urine protein-to-creatinine; IQR, interquartile range.
a
Expressed as mean ± SD or median (IQR).
b
Expressed as total number of patients (number in steroid group/number in control group).
c
The event was defined as a composite of ESRD or either doubling in serum creatinine or halving of GFR.
d
ESRD.
e
Doubling in serum creatine.
f
Halving of GFR.