Active vitamin D treatment for reduction of residual proteinuria: a systematic review
de Borst MH, Hajhosseiny R, Tamez H, Wenger J, Thadhani R, Goldsmith DJ
Journal of the American Society of Nephrology : JASN · 103 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- NIDDK NIH HHS
- Subvenciones
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK094872)
Según 2 financiadores declarados.
Publicación
- Publicado
- 2013-08-09 · J Am Soc Nephrol · vol. 24 · número 11 · págs. 1863–1871
- Editorial
- American Society of Nephrology
- Citado
- 138 citas · más que el 99% de estudios similares · 11.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 56 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Chronic Kidney Disease and Diabetes · Vitamin D Research Studies · Parathyroid Disorders and Treatments
- Palabras clave
- active vitamin D analogs, chronic kidney disease, paricalcitol, 1,25-dihydroxyvitamin D3, renin-angiotensin-aldosterone system blockade, ACE inhibitors, angiotensin receptor blockers, proteinuria reduction, disease progression
- MeSH
- humans, proteinuria, vitamin d, angiotensin-converting enzyme inhibitors, renal insufficiency, chronic, randomized controlled trials as topic, angiotensin receptor antagonists
6 autores
- Martin H. de Borst🇳🇱 · autor de correspondenciaUniversity Medical Center Groningen; University of Groningen
- Reza Hajhosseiny🇬🇧🇺🇸Guy's Hospital; Massachusetts General Hospital; Kings Health Partners
- Hector E. Tamez🇺🇸Massachusetts General Hospital
- Julia Wenger🇺🇸Massachusetts General Hospital
- Ravi Thadhani🇺🇸Massachusetts General Hospital
- David Goldsmith🇬🇧Guy's Hospital; Kings Health Partners
Resumen
El texto original del estudio, en el idioma en que se publicó.
Despite renin-angiotensin-aldosterone system blockade, which retards progression of CKD by reducing proteinuria, many patients with CKD have residual proteinuria, an independent risk factor for disease progression. We aimed to address whether active vitamin D analogs reduce residual proteinuria. We systematically searched for trials published between 1950 and September of 2012 in the Medline, Embase, and Cochrane Library databases. All randomized controlled trials of vitamin D analogs in patients with CKD that reported an effect on proteinuria with sample size≥50 were selected. Mean differences of proteinuria change over time and odds ratios for reaching ≥15% proteinuria decrease from baseline to last measurement were synthesized under a random effects model. From 907 citations retrieved, six studies (four studies with paricalcitol and two studies with calcitriol) providing data for 688 patients were included in the meta-analysis. Most patients (84%) used an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker throughout the study. Active vitamin D analogs reduced proteinuria (weighted mean difference from baseline to last measurement was -16% [95% CI, -13% to -18%]) compared with controls (+6% [95% CI, 0% to +12%]; P<0.001). Proteinuria reduction was achieved more commonly in patients treated with an active vitamin D analog (204/390 patients) than control patients (86/298 patients; OR, 2.72 [95% CI, 1.82 to 4.07]; P<0.001). Thus, active vitamin D analogs may further reduce proteinuria in CKD patients in addition to current regimens. Future studies should address whether vitamin D therapy also retards progressive renal functional decline.
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