Table 1.
Main Characteristics of the included studies
| Studies | Patients | Sample size | CNIs group | Follow-up (mo) | Control | Definitions of PR and CR | Drop-in (CNI/control) | ACEI/ARB | Jadad score |
|---|---|---|---|---|---|---|---|---|---|
| Lai 1987 [4] | proteinuria ≥ 1.5 g/day, eGFR > 50 ml/min/1 73 m2 | 19 (9/10) | CsA 5 mg/kg/day, then reduced by increments of 25% every 4 days over 2 weeks | 3/6 | placebo | CR: Proteinuria less than 0.5 g/day. PR: proteinuria reduced to at least half of the baseline measurement and an absolute value of >0.5 g/day). | 1/0 | -- | 7 |
| Liu 2014 [15] | proteinuria >1.0 g/day eGFR > 30 mL/min/1.73 m2 | 48 (24/24) | CsA 3 mg/kg/day with low-dose MP (8 mg/day). Twelve weeks later, the dose was gradually reduced by 50 mg every month then maintained at a maintenance dose of 25 mg/day. |
12/12 | MP 0.8 mg/kg/day (max 48 mg/day) | CR: Proteinuria less than 0.3 g/day. PR: proteinuria reduced to at least half of the initial level and an absolute value of >0.3 g/day). | 3/1 | losartan (50 mg/day) | 3 |
| Xu 2014 [16] | proteinuria >1.0 g/day <3.5 g/day eGFR ≥ 60 mL/min/1.73 m2 or scr < 150umol/L |
96 (48/48) | CsA 3 mg/kg/day for 3 months, then 2 mg/kg/day for 9 months; PDN 0.6–0.8 mg/kg/day (max 40 mg/day), then tapered | 12/12 | PDN 1 mg/kg/day (max 60 mg/day) | CR: proteinuria < 0.5 g/day, serum albumin > 35 g/L, and normal Scr. PR: proteinuria reduced by >25% but still higher than 0.5 g/day, and stable Scr. |
0/0 | Valsartan 80–160 mg/day | 3 |
| Kim 2013 [17] | eGFR >45 mL/min/1.73 m2 or scr < 1.5 mg/dl UACR ≥ 0.3 and <3 g/g creatinine | 40 (20/20) | TAC 0.1 mg/kg/day, After 8 weeks reduced to 0.05 mg/kg/day | 3/3 | placebo | -- | 1/0 | ARB10/20,8/20 | 7 |
| Zhang 2013 [14] | proteinuria >1.0 g/day <3.5 g/day eGFR >60 mL/min/1.73 m2 or scr < 221umol/L |
25 (11/14) | TAC 0.075 mg/(kg · d), then tapered. PDN 30 mg/day, then tapered | 6/6 | PDN 0.5 mg/kg/day (max 60 mg/day) | CR: proteinuria < 0.3 g/day, and normal Scr. PR: proteinuria reduced by >30% but still higher than 0.3 g/24 h, and stable Scr. |
0/0 | -- | 2 |
| Ou-yang 2015 [13] | eGFR >45 mL/min/1.73 m2 or scr < 1.5 mg/dl UACR ≥ 0.3 and <3 g/g creatinine | 56 (28/28) | CsA 100 mg/day, then tapered, MP 0.5 mg/kg/day (max 36 mg/day) | 6/6 | MP 0.8 mg/kg/day (max 48 mg/day) | CR was defined as proteinuria < 0.3 g/24 h, and normal Scr. PR was defined as proteinuria reduced by >30% but still higher than 0.3 g/24 h, and stable Scr. |
1/0 | losartan (100 mg/day) | 7 |
| Liu 2015 [12] | proteinuria >3.5 g/day scr < 150umol/L | 90 (45/45) | CsA 100 mg/day; PDN 1 mg/kg/day, then tapered | 3/3 | PDN 1 mg/kg/day, then tapered | -- | 0/0 | -- | 2 |
Drop in, patients who are randomized to standard/control arm but start taking/using the experimental treatment; Scr serum creatinine, MP methyl prednisolone, PDN prednisolone, UACR urine albumin to creatinine ratio, CsA Cyclosporine A, TAC Tacrolimus, CNI Calcineurin inhibitor, PR Partial remission rate, CR Complete remission rate