Interventions for preventing and treating kidney disease in IgA vasculitis

Deirdre Hahn; Elisabeth M Hodson; Jonathan C Craig

doi:10.1002/14651858.CD005128.pub4

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Respuestas clínicas Cochrane
Guías
Temas

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Figure 1

Flow diagram of study selection

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias: Review authors' judgements about each methodological quality item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias: Review authors' judgements about each risk of bias item for each included study

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 1: Persistent kidney disease at any time after treatment

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 2: Number of children with any continuing kidney disease at different time points

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 3: Any continuing kidney disease at different time points (study with high risk of bias excluded)

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 4: Number of children with kidney disease in first month/with kidney disease at follow‐up

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 5: Number developing severe kidney disease

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 6: Duration of kidney disease

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 7: Gastrointestinal complications requiring hospital admission

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1: Prednisone versus placebo/supportive treatment for preventing persistent kidney disease, Outcome 8: Eight‐year outcomes

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2: Antiplatelet agents versus supportive treatment for preventing persistent kidney disease, Outcome 1: Kidney disease at any time

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3: Heparin versus placebo for preventing persistent kidney disease, Outcome 1: Any kidney disease at 2 to 3 months after onset or relapse

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3: Heparin versus placebo for preventing persistent kidney disease, Outcome 2: Type of kidney disease at 2 to 3 months or more after onset or relapse

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3: Heparin versus placebo for preventing persistent kidney disease, Outcome 3: Time to development of kidney disease

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4: Cyclophosphamide versus supportive treatment for treating severe kidney disease, Outcome 1: Persistent kidney disease

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4: Cyclophosphamide versus supportive treatment for treating severe kidney disease, Outcome 2: Persistent severe kidney disease

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.3

Comparison 4: Cyclophosphamide versus supportive treatment for treating severe kidney disease, Outcome 3: ESKD

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5: Cyclophosphamide + steroids versus steroids for treating severe kidney disease, Outcome 1: Primary outcome: BVAS at 6 months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.2

Comparison 5: Cyclophosphamide + steroids versus steroids for treating severe kidney disease, Outcome 2: Secondary endpoints at 12 months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.3

Comparison 5: Cyclophosphamide + steroids versus steroids for treating severe kidney disease, Outcome 3: Adverse effects

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.1

Comparison 6: Tacrolimus versus IV cyclophosphamide for treating severe kidney disease, Outcome 1: Number with resolution of proteinuria and haematuria at 2 years

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.2

Comparison 6: Tacrolimus versus IV cyclophosphamide for treating severe kidney disease, Outcome 2: Number with recurrence of proteinuria and haematuria at 2 years

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.3

Comparison 6: Tacrolimus versus IV cyclophosphamide for treating severe kidney disease, Outcome 3: Laboratory parameters

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.4

Comparison 6: Tacrolimus versus IV cyclophosphamide for treating severe kidney disease, Outcome 4: Adverse effects

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.1

Comparison 7: Cyclosporin versus methylprednisolone for treating severe kidney disease, Outcome 1: Number with remission at 3 months

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.2

Comparison 7: Cyclosporin versus methylprednisolone for treating severe kidney disease, Outcome 2: Number with remission at last follow‐up (mean 6.3 years)

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.1

Comparison 8: Mycophenolate mofetil versus IV cyclophosphamide for treating severe kidney disease, Outcome 1: Number with complete remission

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.2

Comparison 8: Mycophenolate mofetil versus IV cyclophosphamide for treating severe kidney disease, Outcome 2: Number with complete or partial remission

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.3

Comparison 8: Mycophenolate mofetil versus IV cyclophosphamide for treating severe kidney disease, Outcome 3: Adverse effects

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.1

Comparison 9: Mycophenolate mofetil versus azathioprine for treating severe kidney disease, Outcome 1: Remission of proteinuria at 1 year

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.2

Comparison 9: Mycophenolate mofetil versus azathioprine for treating severe kidney disease, Outcome 2: Regression of histological lesions at 1 year

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.3

Comparison 9: Mycophenolate mofetil versus azathioprine for treating severe kidney disease, Outcome 3: Relapse of IgAV

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.4

Comparison 9: Mycophenolate mofetil versus azathioprine for treating severe kidney disease, Outcome 4: Glomerular filtration rate

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.1

Comparison 10: Mycophenolate mofetil versus leflunomide for treating severe kidney disease, Outcome 1: 24‐hour urine proteinuria

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.1

Comparison 11: Double filtration plasmapheresis versus no plasmapheresis for treating severe kidney disease, Outcome 1: Remission

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.2

Comparison 11: Double filtration plasmapheresis versus no plasmapheresis for treating severe kidney disease, Outcome 2: Adverse effects

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 12.1

Comparison 12: Fosinopril + supportive treatment versus supportive treatment for treating proteinuria in IgAV, Outcome 1: Proteinuria

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary of findings 1. Prednisone versus placebo or supportive treatment for preventing persistent kidney disease in patients with IgAV (Henoch‐ Schönlein Purpura)

Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)
Prednisone versus placebo or supportive treatment for preventing persistent kidney disease in patients with IgAV (Henoch‐Schönlein Purpura)
Patient or population: patients with IgAV Settings: all settings Intervention: prednisone Comparison: placebo or supportive treatment
	Assumed risk	Corresponding risk
	Placebo or supportive treatment	Prednisone
Persistent kidney disease at any time after treatment	143 per 1000	106 per 1000 (60 to 189)	RR 0.74 (0.42 to 1.32)	746 (5)	⊕⊕⊕⊝ Moderate¹
Children with any continuing kidney disease at 3 months	199 per 1000	165 per 1000 (92 to 303)	RR 0.83 (0.46 to 1.52)	655 (4)	⊕⊕⊕⊝ Moderate²
Children with any continuing kidney disease at 6 months	100 per 1000	51 per 1000 (24 to 111)	RR 0.51 (0.24 to 1.11)	379 (3)	⊕⊕⊕⊝ Moderate²
Children with any continuing kidney disease at 12 months	84 per 1000	89 per 1000 (32 to 244)	RR 1.06 (0.38 to 2.91)	455 (3)	⊕⊕⊝⊝ Low^2,3
Any continuing kidney disease at 3 months (study with high risk of bias excluded)	243 per 1000	238 per 1000 (170 to 330)	RR 0.98 (0.70 to 1.36)	487 (3)	⊕⊕⊕⊕ High
Any continuing kidney disease at 12 months (study with high risk of bias excluded)	105 per 1000	146 per 1000 (79 to 272)	RR 1.39 (0.75 to 2.59)	287 (2)	⊕⊕⊕⊝ Moderate^3,4
Number developing severe kidney disease	14 per 1000	22 per 1000 (6 to 85)	RR 1.58 (0.42 to 6)	418 (2)	⊕⊕⊝⊝ Low^3,5
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in the footnotes. The corresponding risk (and its 95% CI) 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: Further research is very unlikely to change our confidence in the estimate of effect Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low certainty: We are very uncertain about the estimate
¹ Two studies had unclear or biased allocation concealment & were not blinded ² One study had inadequate allocation concealment & no blinding & one study had large loss to follow‐up ³ 30% loss to follow‐up in largest included study ⁴ Small numbers of patients and events ⁵ Small numbers of events

Summary of findings 1. Prednisone versus placebo or supportive treatment for preventing persistent kidney disease in patients with IgAV (Henoch‐ Schönlein Purpura)

Ir a la tabla de la revisión

Comparison 1. Prednisone versus placebo/supportive treatment for preventing persistent kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1.1 Persistent kidney disease at any time after treatment Show forest plot	5	746	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.42, 1.32]

1.2 Number of children with any continuing kidney disease at different time points Show forest plot	4		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

1.2.1 One month	4	655	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.34, 1.84]
1.2.2 Three months	4	655	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.46, 1.52]
1.2.3 Six months	3	379	Risk Ratio (M‐H, Random, 95% CI)	0.51 [0.24, 1.11]
1.2.4 Twelve months	3	455	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.38, 2.91]
1.3 Any continuing kidney disease at different time points (study with high risk of bias excluded) Show forest plot	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

1.3.1 One month	3	487	Risk Ratio (M‐H, Random, 95% CI)	1.02 [0.54, 1.93]
1.3.2 Three months	3	487	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.70, 1.36]
1.3.3 Six months	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.23, 1.50]
1.3.4 Twelve months	2	287	Risk Ratio (M‐H, Random, 95% CI)	1.39 [0.75, 2.59]
1.4 Number of children with kidney disease in first month/with kidney disease at follow‐up Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

1.4.1 One month	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.4.2 Three months	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.4.3 Six months	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.5 Number developing severe kidney disease Show forest plot	2	418	Risk Ratio (M‐H, Random, 95% CI)	1.58 [0.42, 6.00]

1.6 Duration of kidney disease Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

1.6.1 Haematuria	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
1.6.2 Proteinuria	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
1.7 Gastrointestinal complications requiring hospital admission Show forest plot	3	517	Risk Ratio (M‐H, Random, 95% CI)	0.56 [0.25, 1.23]

1.8 Eight‐year outcomes Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

1.8.1 Haematuria	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.8.2 Proteinuria	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.8.3 Haematuria and proteinuria	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.8.4 Hypertension	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
1.8.5 Decreased GFR (Schwartz formula)	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 1. Prednisone versus placebo/supportive treatment for preventing persistent kidney disease

Ir a la tabla de la revisión

Comparison 2. Antiplatelet agents versus supportive treatment for preventing persistent kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
2.1 Kidney disease at any time Show forest plot	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

2.1.1 Dipyridamole ± cyproheptadine in children without kidney disease at entry	2	101	Risk Ratio (M‐H, Random, 95% CI)	1.16 [0.46, 2.95]
2.1.2 Dipyridamole ± cyproheptadine in children with kidney disease at entry	1	19	Risk Ratio (M‐H, Random, 95% CI)	0.92 [0.23, 3.72]
2.1.3 Aspirin versus supportive treatment	1	18	Risk Ratio (M‐H, Random, 95% CI)	0.14 [0.01, 2.42]

Comparison 2. Antiplatelet agents versus supportive treatment for preventing persistent kidney disease

Ir a la tabla de la revisión

Comparison 3. Heparin versus placebo for preventing persistent kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
3.1 Any kidney disease at 2 to 3 months after onset or relapse Show forest plot	2	317	Risk Ratio (M‐H, Random, 95% CI)	0.48 [0.15, 1.54]

3.2 Type of kidney disease at 2 to 3 months or more after onset or relapse Show forest plot	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

3.2.1 Haematuria	2	317	Risk Ratio (M‐H, Random, 95% CI)	0.39 [0.07, 2.21]
3.2.2 Proteinuria	2	317	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.31, 0.73]
3.2.3 Nephrotic syndrome	1	228	Risk Ratio (M‐H, Random, 95% CI)	0.31 [0.03, 2.89]
3.3 Time to development of kidney disease Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Subtotals only

Comparison 3. Heparin versus placebo for preventing persistent kidney disease

Ir a la tabla de la revisión

Comparison 4. Cyclophosphamide versus supportive treatment for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
4.1 Persistent kidney disease Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

4.2 Persistent severe kidney disease Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

4.3 ESKD Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

Comparison 4. Cyclophosphamide versus supportive treatment for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 5. Cyclophosphamide + steroids versus steroids for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
5.1 Primary outcome: BVAS at 6 months Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

5.1.1 BVAS = 0 at 6 months	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.1.2 Improvement in BVAS score	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2 Secondary endpoints at 12 months Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

5.2.1 BP > 125/75 mm Hg	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2.2 eGFR < 60 mL/min	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2.3 Proteinuria > 1 g/day	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2.4 RAS blockers	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2.5 Kidney function improvement > 50%	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2.6 ESKD	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.2.7 Death	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
5.3 Adverse effects Show forest plot	1		Risk Difference (M‐H, Random, 95% CI)	Totals not selected

5.3.1 infection	1		Risk Difference (M‐H, Random, 95% CI)	Totals not selected
5.3.2 Newly diagnosed or deterioration in existing diabetes	1		Risk Difference (M‐H, Random, 95% CI)	Totals not selected
5.3.3 Depression/anxiety	1		Risk Difference (M‐H, Random, 95% CI)	Totals not selected
5.3.4 Alopecia	1		Risk Difference (M‐H, Random, 95% CI)	Totals not selected
5.3.5 Insomnia	1		Risk Difference (M‐H, Random, 95% CI)	Totals not selected

Comparison 5. Cyclophosphamide + steroids versus steroids for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 6. Tacrolimus versus IV cyclophosphamide for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
6.1 Number with resolution of proteinuria and haematuria at 2 years Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

6.1.1 Number without proteinuria	1	170	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.99, 1.30]
6.1.2 Number without haematuria	1	170	Risk Ratio (M‐H, Random, 95% CI)	1.18 [1.02, 1.37]
6.2 Number with recurrence of proteinuria and haematuria at 2 years Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

6.2.1 Number with proteinuria	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.45, 1.15]
6.2.2 Number with haematuria	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.61, 1.48]
6.3 Laboratory parameters Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Subtotals only

6.3.1 Serum creatinine at 3 months	1	170	Mean Difference (IV, Random, 95% CI)	‐1.00 [‐2.80, 0.80]
6.3.2 Serum creatinine at 6 months	1	170	Mean Difference (IV, Random, 95% CI)	‐1.00 [‐2.06, 0.06]
6.3.3 24‐hour urinary protein at 3 months	1	170	Mean Difference (IV, Random, 95% CI)	‐0.31 [‐0.40, ‐0.22]
6.3.4 24‐hour urinary protein at 6 months	1	170	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐0.24, ‐0.16]
6.3.5 Urine RBC/HPF at 3 months	1	170	Mean Difference (IV, Random, 95% CI)	‐2.62 [‐3.79, ‐1.45]
6.3.6 Urine RBC/HPF at 6 months	1	170	Mean Difference (IV, Random, 95% CI)	‐2.45 [‐2.90, ‐2.00]
6.4 Adverse effects Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

6.4.1 Leucopenia	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.64 [0.19, 2.17]
6.4.2 Respiratory infections	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.38, 0.82]
6.4.3 Abnormal liver function tests	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.92 [0.58, 1.45]
6.4.4 Urinary tract infection	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.56 [0.27, 1.15]
6.4.5 Poor appetite	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.47, 1.42]
6.4.6 Other serious adverse effect	1	170	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.20, 0.98]

Comparison 6. Tacrolimus versus IV cyclophosphamide for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 7. Cyclosporin versus methylprednisolone for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
7.1 Number with remission at 3 months Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

7.2 Number with remission at last follow‐up (mean 6.3 years) Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

Comparison 7. Cyclosporin versus methylprednisolone for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 8. Mycophenolate mofetil versus IV cyclophosphamide for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
8.1 Number with complete remission Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

8.1.1 Three months	1	68	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.72, 1.99]
8.1.2 Six months	1	68	Risk Ratio (M‐H, Random, 95% CI)	1.02 [0.78, 1.34]
8.1.3 Twelve months	1	68	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.83, 1.35]
8.2 Number with complete or partial remission Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

8.2.1 Three months	1	68	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.75, 1.02]
8.2.2 Six months	1	68	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.75, 1.02]
8.2.3 Twelve months	1	68	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.75, 1.02]
8.3 Adverse effects Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

8.3.1 Cerebral abscess	1	68	Risk Ratio (M‐H, Random, 95% CI)	0.35 [0.01, 8.37]
8.3.2 Abnormal LFTS requiring treatment change	1	68	Risk Ratio (M‐H, Random, 95% CI)	5.29 [0.26, 106.33]
8.3.3 Infection	1	68	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.37, 1.35]
8.3.4 Gastrointestinal upsets	1	68	Risk Ratio (M‐H, Random, 95% CI)	3.18 [0.35, 29.08]

Comparison 8. Mycophenolate mofetil versus IV cyclophosphamide for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 9. Mycophenolate mofetil versus azathioprine for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
9.1 Remission of proteinuria at 1 year Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

9.2 Regression of histological lesions at 1 year Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

9.3 Relapse of IgAV Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

9.4 Glomerular filtration rate Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 9. Mycophenolate mofetil versus azathioprine for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 10. Mycophenolate mofetil versus leflunomide for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
10.1 24‐hour urine proteinuria Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Subtotals only

10.1.1 Three months	1	18	Mean Difference (IV, Random, 95% CI)	360.00 [‐48.50, 768.50]
10.1.2 Nine months	1	18	Mean Difference (IV, Random, 95% CI)	49.00 [2.78, 95.22]

Comparison 10. Mycophenolate mofetil versus leflunomide for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 11. Double filtration plasmapheresis versus no plasmapheresis for treating severe kidney disease

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
11.1 Remission Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

11.1.1 Complete remission after 3 courses of treatment	1	60	Risk Ratio (M‐H, Random, 95% CI)	1.43 [0.63, 3.25]
11.1.2 Complete and partial remission after 3 courses of treatment	1	60	Risk Ratio (M‐H, Random, 95% CI)	1.26 [0.91, 1.75]
11.1.3 Complete remission at 6 months	1	60	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.89, 1.44]
11.2 Adverse effects Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

11.2.1 Hypertension	1	60	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.33, 1.82]
11.2.2 Leucopenia	1	60	Risk Ratio (M‐H, Random, 95% CI)	3.00 [0.13, 70.83]
11.2.3 Need for haemodialysis	1	60	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.23, 1.28]
11.2.4 Respiratory infections	1	60	Risk Ratio (M‐H, Random, 95% CI)	1.33 [0.53, 3.38]
11.2.5 GIT disturbances	1	60	Risk Ratio (M‐H, Random, 95% CI)	1.22 [0.59, 2.51]

Comparison 11. Double filtration plasmapheresis versus no plasmapheresis for treating severe kidney disease

Ir a la tabla de la revisión

Comparison 12. Fosinopril + supportive treatment versus supportive treatment for treating proteinuria in IgAV

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
12.1 Proteinuria Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

12.1.1 Complete remission of proteinuria < 150 mg/day	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
12.1.2 Partial remission	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
12.1.3 Minimal response/no response	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 12. Fosinopril + supportive treatment versus supportive treatment for treating proteinuria in IgAV

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet

Scolaris Content Display Scolaris Content Display

Temas

Scolaris Language Selector Scolaris Language Selector

Scolaris Content Display Scolaris Content Display

Instituciones a las que se accedió previamente

Scolaris Content Display Scolaris Content Display

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso

	Idioma de la Revisión Cochrane Escoja su idioma de preferencia para las revisiones Cochrane y otros contenidos. Las secciones sin una traducción aparecerán en inglés.

	Idioma de la web Escoja su idioma de preferencia para la web de la Biblioteca Cochrane.

Idioma de la Revisión Cochrane

Idioma de la web

Contenido relacionado

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Temas

Copiar o descargar referencia

Idioma de la Revisión Cochrane

Idioma de la web

Instituciones a las que se accedió previamente

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso