title: Steroids in the treatment of IgA nephropathy to the improvement of renal survival: a systematic review and meta-analysis.
abstract: BACKGROUND
  Studies have shown that steroids can improve kidney survival and decrease the risk of proteinuria in patients with Immunoglobulin A nephropathy, but the overall benefit of steroids in the treatment of Immunoglobulin A nephropathy remains controversial. The aim of this study was to evaluate the benefits and risks of steroids for renal survival in adults with Immunoglobulin A nephropathy.
  
  
  RESULTS
  We searched the Cochrane Renal Group Specialized Register, Cochrane Controlled Trial Registry, MEDLINE and EMBASE databases. All eligible studies were measuring at least one of the following outcomes: end-stage renal failure, doubling of serum creatinine and urinary protein excretion. Fifteen relevant trials (n = 1542) that met our inclusion criteria were identified. In a pooled analysis, steroid therapy was associated with statistically significant reduction of the risk in end-stage renal failure (RR: 0.46, 95% CI: 0.27 to 0.79), doubling of serum creatinine (RR = 0.34, 95%CI = 0.15 to 0.77) and reduced urinary protein excretion (MD = -0.47 g/day, 95%CI = -0.64 to -0.31).
  
  
  CONCLUSIONS
  We identified that steroid therapy was associated with a decrease of proteinuria and with a statistically significant reduction of the risk in end-stage renal failure. Moreover, subgroup analysis also suggested that long-term steroid therapy had a higher efficiency than standard and short term therapy.
authors.affiliation: Department of Health Statistics, Second Military Medical University, Shanghai, China.
authors.forename: Yu-Hao
authors.initials: YH
authors.lastname: Zhou
authors.forename: Li-Gong
authors.initials: LG
authors.lastname: Tang
authors.forename: Shi-Lei
authors.initials: SL
authors.lastname: Guo
authors.forename: Zhi-Chao
authors.initials: ZC
authors.lastname: Jin
authors.forename: Mei-Jing
authors.initials: MJ
authors.lastname: Wu
authors.forename: Jia-Jie
authors.initials: JJ
authors.lastname: Zang
authors.forename: Jin-Fang
authors.initials: JF
authors.lastname: Xu
authors.forename: Chun-Fang
authors.initials: CF
authors.lastname: Wu
authors.forename: Ying-Yi
authors.initials: YY
authors.lastname: Qin
authors.forename: Qing
authors.initials: Q
authors.lastname: Cai
authors.forename: Qing-Bin
authors.initials: QB
authors.lastname: Gao
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Zhang
authors.forename: Dand-Hui
authors.initials: DH
authors.lastname: Yu
authors.forename: Jia
authors.initials: J
authors.lastname: He
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007677:Kidney Function Tests; D011507:Proteinuria
chemical_list: D000305:Adrenal Cortex Hormones; D003404:Creatinine