Glucocorticoid Treatment Proteinuria Of IgA Nephropathy: A Meta-Analysis

Objective：By meta analysis to explore the effect of glucocorticoid on IgANproteinuriaMethods： We systematically searched Science Direct, EBSCO, Wiley, PubMed,CBMdisc and China National Knowledge Infrastructure for randomized, controlledtrials of corticosteroid therapy for IgA nephropathy published between1995andMarch2013. Data were extracted by two independent authors and SWD with95%confidence interval (CI) was calculated. The overall efficacy、different gradient andsubgroup analyses (course of treatment, intensive treatment) were analyzed.Result：Nine trials, including256cases and273controls, were reviewed in thepresent Meta-analysis.1).Overall, steroid therapy was associated with a reduction inproteinuria (-0.51[95%CI,-0.68to-0.33])(P=0.00001).2）.Subgroup analysissuggested that Glucocorticoid treatment the curative effect of proteinuria were betterthan the control group and the steroid was effective to patients with under1.5g/d toovertop1.5g/d of proteinuria (P<0.01)3）. For serum creatinine is less than1.5mg/dlin patients with IgA nephropathy Glucocorticoid treatment the curative effect ofproteinuria is better than that of control group (P <0.01)4).Both short-term andlong-term glucocorticoid therapy were more effective than control(P<0.01).5).Strengthening support therapy than sheer application the curative effectof ACEI drugs for albuminuria more significant (P <0.01) Conclusion:1) Glucocorticoid treatment of IgAN proteinuria effect is obvious;2) The greater the proteinuria IgAN application of glucocorticoids to reduce the roleof urine protein may be the better;3) it is not clear application of glucocorticoids to reduce proteinuria curative effectdifference between different courses;4) strengthening support therapy (hormones and ACEI combined use of) a simpleapplication of ACEI drugs can more effectively reduce the patients with IgAnephropathy proteinuria, slow kidney disease progress;...