Table 1 Characteristics of RCTs included in the study
Study | Patient | Sample size | Intervention (treatment) | Intervention (control) | Follow-up |
|---|---|---|---|---|---|
Ballardie 2002 [10] | 18 to 54 years | 38(19/19) | Prednisolone 40 mg/d (reduced to 10 mg/d by 2 year) + cyclophosphamide 1.5 mg/kg/day (adjusted down to the nearest 50 mg) | no immunosuppression | 24 M |
Cheng 2015 [11] | 18–55 years old, hypertension under control, urinary proteins 0.5–3.5 g/24 h, Cr < 265.2 μmol/L | 84(42/42) | leflunomide 20 mg/d + Valsartan | Valsartan | 24 M |
Cruzado 2011 [12] | 18–70 years old, eGFR 30-60 ml/min/1.73m2, proteinuria > 1 g/d; BP > 140/90 mmHg with proteinuria 0.3-1 g/d | 23(14/9) | SRL 1 mg/d (initial) + enalapril (or ACEI) + atorvastatin (or other statin) | Enalapril (or ACEI) + atorvastatin (or other statin) | 12 M |
Frisch 2005 [13] | 18–75 years old, protein> 1 g/d | 32(17/15) | MMF 1000 mg bid +ACEI/ARB | Placebo + ACEI/ARB | 12 M |
Harmankaya 2002 [14] | 13–63 years, mean Ccr 89.2 ± 10.2 ml/min | 43(21/22) | Prednisolone 40 mg/day + azathioprine 100 mg/day | no specific treatment | 60 M |
Hirai 2017 [15] | urinary protein excretion > 0.5 g/day, age > 16 years | 42(21/21) | MZR 150 mg once daily orally in the morning for 12 months + Standard treatment | Standard treatment | 36 M |
Hogg 2015 [16] | 7–70 years old; UPCR > 0.6 g/g (males) or > 0.8 g/g (females); eGFR> 50 mL/min/1.73 m2 (or > 40 mL/min/1.73 m2 in those already receiving ACE or ARB). | 52(25/27) | MMF 25 to 36 mg/kg/d (Max dose of 1 g/d) + lisinopril | lisinopril or placebo 25 to 36 mg/kg/d (Max dose of 1 g/d) | 12 M |
Julian 1993 [17] | Ccr > 25 ml/min/1.73 m2 | 35(17/18) | prednisone | no placebo | 12 M |
Yoshikawa 1999a [18] | < 15 Years old | 78(40/38) | Prednisolone 2 mg/kg/d in three divided doses for a total dose of not more than 80 mg/d for 4w, followed by 2 mg/kg /2d, given as a single dose in the morning of every other day for 4w, 1.5 mg/kg/2d for 4w, and 1 mg/kg/2d for 21 m + azathioprine 2 mg/kg/d in a single morning dose for 24 m + heparin-warfarin + dipyridamole | heparin-warfarin + dipyridamole | 24 M |
Katafuchi 2003 [19] | ≤60 years old, Cr < 1.5 mg/dl(132.6umol/L) | 90(43/47) | prednisolone orally: 20 mg/d for 1 month, followed by 15 mg/d for 1 month, 10 mg/d for 1 month, 7.5 mg/d for 3 months, and 5 mg/d for 18 months + dipyridamole 150–300 mg/day | Dipyridamole 150–300 mg/day | 60 M |
Kim 2013 [20] | 18–70 years old, serum creatinine ≤1.5 mg/dL or eGFR ≥45 ml/min/1.73 m2, UACR 0.3-3 g/g creatinine, BP < 130/80 mmHg | 40(20/20) | Tacrolimus 0.1 mg/kg/day, 8 weeks (maintain trough levels at 5–10 ng/ml) → 0.05 mg/kg/day, 16 weeks (maintain the trough level in 5–10 ng/ml) + RASi(9/20) | RASi(11/20), placebo | 16 W |
Koike 2008 [21] | NA | 48(24/24) | initially treated with 0.4 mg/kg/day of prednisolone (20–30 mg/day) for the first 4 weeks, and the dose was gradually reduced to 10–20 mg on alternate days for the next 12 months, and then 5–10 mg on alternate days for a subsequent year | Dipyridamole or dilazep hydrochloride | 24 M |
Pozzi 1999b [22] | 15–69 years old, urinary protein excretion of 1.0–3.5 g/d, Cr ≤ 133 umol/L (1.5 mg/dL) | 86(43/43) | methylprednisolone intravenously for 3 consecutive days; this course was repeated 2 months and 4 months later. Oral prednisone was given at a dose of 0.5 mg/kg on alternate days for 6 months. | Supportive treatment | 60 M |
Lai 1986 [23] | 14–42 years old, IgAN & NS | 34(17/17) | prednisone/prednisolone 40-60 mg/d, reduce by half after 8 weeks | Supportive therapy | 38 M |
Lv 2009 [24] | 18–65 years old, urinary proteins 1–5 g/d, eGFR> 30 ml/min | 63(33/30) | prednisone: 0.8–1.0 mg/kg/day for 8 weeks, tapered by 5–10 mg every 2 weeks + cilazapril | cilazapril | 48 M |
Lv 2017 [25] | proteinuria> 1 g/d, eGFR: 20 -120 ml/min/1.73m2 | 262(136/126) | oral methylprednisolone (0.6–0.8 mg/kg/d; maximum, 48 mg/d) | placebo | 60 M |
Maes 2004 [26] | > 18 years old, inulin clearance 20–70 mL/min/1.73m2, proteinuria > 1 g/day, BP > 140/90 mmHg, | 34(21/13) | MMF: 2 g/d + ACEI | Placebo (identical lactose-containing capsules) | 36 M |
Manno 2009 [27] | 16–70 years old, proteinuria> 1 g/d, eGFR≥50 ml/min/1.73m2 | 97(48/49) | prednisone: 1.0 mg/kg/day (Max: 75 mg/day) for 2 months, tapered by 0.2 mg/kg/day every month ramipril | ramipril | 5Y |
Rauen 2015 [28] | proteinuria> 0.75 g/d after 6 months support treatment | 162(82/80) | Supportive Care (100%) + Immunosuppression | RASi (77/80) | 36 M |
Shoji 2000 [29] | 15–55 years old, proteinuria less than 1.5 g/d, serum creatinine level less than 1.5 mg/dL | 19(11/8) | prednisolone 0.8 mg/kg of body weight; this was gradually reduced to a daily dose of 0.4 mg/kg of body weight during the first month of therapy, and then tapered to 10 mg very other day for the remainder of the 1 year of therapy | Dipyridamole 300 mg/day | 12 M |
Tang 2005c[30] | urinary proteins> 1 g/d, BP < 125/85 mmHg, Cr < 300umol/L(3.4 mg/dl) | 40(20/20) | MMF 2 g/day (weight ≥ 60 kg), 1.5 g/day (weight < 60 kg) + ACEI/ARB(16:4) | ACEI/ARB (14:6) | 72 W |
Walker 1990 [31] | 24 h pro> 1.0 g/d, 120umol/L < Cr < 200umol/L one or more | 52(25/27) | Cyclophosphamide (1–2 mg/kg/24 h - maximum of 100 mg/24 h and ajusted according to peripheral white cell counts) + dipyridamole +warfarin | no treatment | 2Y |
Wu 2016 [32] | 18–55 years, proteinuria of 0.5–3.5 g/d, serum creatinine < 265 μmol/L, blood pressure between 90/60 and 130/80 mmHg | 399(100/299) | Leflunomide 20 mg/d + telmisartan + clopidogrel placebo | Telmisartan + Leflunomide placebo + clopidogrel placebo & Telmisartan + clopidogrel + Leflunomide placebo & Telmisartan + clopidogrel | 24w |
Xie 2011 [33] | 14–70 years old, urinary protein excretion: 0.5 to 3.5 g/24 h, Cr < 353.6 umol/L | 64(34/30) | MZR 200 mg/d (weight < 50 kg), 250 mg/d (weight > 50 kg), 150 mg/d (Cr > 176.8 umol/L) + losartan | Losartan | 12 M |
Woo 1987 [34] |  | 48(27/21) | cyclophosphamide 1.5 mg/kg per day+ dipyridamole + warfarin | No treatment | 36 M |