Summary of findings 4. Calcineurin inhibitor regimen versus no calcineurin inhibitor regimen for IgA nephropathy.
| Calcineurin inhibitor regimen versus no calcineurin inhibitor regimen for IgA nephropathy | |||||
|
Patient or population: adults and children who have IgA nephropathy proven on renal biopsy Settings: China Intervention: calcineurin inhibitor regimen (includes calcineurin inhibitor alone or in combination with steroids) Comparison: no calcineurin inhibitor regimen | |||||
| Outcomes | Anticipated absolute benefits* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | |
| Risk without calcineurin inhibitor | Risk with calcineurin inhibitor | ||||
| End‐stage kidney disease | No data observations | Not estimable | No studies | No studies | Not estimable |
|
Complete remission Follow‐up: 0.5 to 1 year |
541 per 1000 | 492 per 1000 (325 to 752) |
RR 0.91 (0.60 to 1.39) |
72 (2) | ⊕⊝⊝⊝ very low 1,2 |
| GFR loss ≥ 50% | No data observations | Not estimable | No studies | No studies | Not estimable |
|
Annual GFR loss (mL/min/ 1.73 m2) |
No data observations | Not estimable | No studies | No studies | Not estimable |
| Death (any cause) | No data observations | Not estimable | No studies | No studies | Not estimable |
|
Infection Follow‐up: 1 year |
130 per 1000 | 40 per 1000 (4 to 356) |
RR 0.31 (0.03 to 2.74) |
48 (1) | ⊕⊝⊝⊝ very low 1,2 |
|
Malignancy Follow‐up: 1 year |
40 per 1000 | 14 per 1000 (1 to 338) |
RR 0.36 (0.02 to 8.45) |
48 (1) | ⊕⊝⊝⊝ very low 1,2 |
| The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio. | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | |||||
1 Downgraded due to study limitations including lack of allocation concealment and lack of blinding
2 Downgraded two levels due to severe imprecision in treatment estimate (consistent with appreciable benefit or harm)