The Efficacy Of The Oxford Classification To Glucocorticoid In IgA Nephropathy:A Meta-analysis

Background: The present review is aimed to evaluate the correlation between pathological features and the response to glucocorticoid in the patients with IgA nephropathy(IgAN)according to the Oxford Classification.Methods: We searched Chinese Biomedical Database,Cochrane Library,Embase,and PubMed with key words and Medical Subject Headings that covered “IgAN” or “IgA nephropathy” or “immunoglobulin A nephropathy” or “IgA nephritis”,and “Oxford Classification”,and “steroid” or “glucocorticoid” or “prednisolone” in Chinese and English.Results: 5 studies with 637 patients were eligible for inclusion.The analysis showed that M1,S1,and T1/2 was strongly associated with the prediction to steroid resistance when compared with M0 [odds ratio(OR)1.89,95% confidence interval(CI)1.01-3.56,P < 0.05],S0(OR 2.24,95% CI 0.99-5.08,P = 0.05)and T0(OR 2.16,95% CI 1.29-3.63,P = 0.004)respectively.There is no difference in steroid sensitivity between E0 and E1(P = 0.55).The pooled OR of steroid resistance for E1 versus T1/2 is 0.50(95% CI 0.25-0.98,P = 0.04).Conclusion: IgAN patients with serious pathological changes(M1,S1,and T1/2)were more resistant to steroid than slight ones(M0,S0,and T0),and E1 is better response to steroid therapy than T1/2.