Interventions for minimal change disease in adults with nephrotic syndrome

Palmer, Suetonia C.; Nand, Kushma; Strippoli, Giovanni F.M.

doi:10.1002/14651858.cd001537.pub4

Cited by 33 publications

(27 citation statements)

References 61 publications

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“…We obtained the search terms used for filter development from the following sources: US National Library of Medicine (NLM) medical subject heading (MeSH) thesaurus using Medline MeSH browser [22], Medline permuted index [23], Emtree thesaurus [24], SNOMED clinical terms, nephrology textbooks [25], clinical practice guidelines [26,27], systematic reviews [28-33], website glossaries, and clinician and librarian opinion. All terms considered potentially useful by any member of our team were included.…”

Section: Methodsmentioning

confidence: 99%

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Glomerular disease search filters for Pubmed, Ovid Medline, and Embase: a development and validation study

Hildebrand

Iansavichus

Lee

et al. 2012

BMC Med Inform Decis Mak

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BackgroundTools to enhance physician searches of Medline and other bibliographic databases have potential to improve the application of new knowledge in patient care. This is particularly true for articles about glomerular disease, which are published across multiple disciplines and are often difficult to track down. Our objective was to develop and test search filters for PubMed, Ovid Medline, and Embase that allow physicians to search within a subset of the database to retrieve articles relevant to glomerular disease.MethodsWe used a diagnostic test assessment framework with development and validation phases. We read a total of 22,992 full text articles for relevance and assigned them to the development or validation set to define the reference standard. We then used combinations of search terms to develop 997,298 unique glomerular disease filters. Outcome measures for each filter included sensitivity, specificity, precision, and accuracy. We selected optimal sensitive and specific search filters for each database and applied them to the validation set to test performance.ResultsHigh performance filters achieved at least 93.8% sensitivity and specificity in the development set. Filters optimized for sensitivity reached at least 96.7% sensitivity and filters optimized for specificity reached at least 98.4% specificity. Performance of these filters was consistent in the validation set and similar among all three databases.ConclusionsPubMed, Ovid Medline, and Embase can be filtered for articles relevant to glomerular disease in a reliable manner. These filters can now be used to facilitate physician searching.

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Section: Methodsmentioning

confidence: 99%

“…We formulated six clinical questions, each which could be answered by a recent corresponding systematic review [28-33]. These systematic reviews were then used as a reference source for relevant articles on the given topic.…”

Section: Methodsmentioning

confidence: 99%

Glomerular disease search filters for Pubmed, Ovid Medline, and Embase: a development and validation study

Hildebrand

Iansavichus

Lee

et al. 2012

BMC Med Inform Decis Mak

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“…However, patients treated with prednisone went into remission more rapidly; 12 of 14 treated patients were in complete remission before 2 months, compared to 6 of 14 controls. 124, 136 …”

Section: Rationalementioning

confidence: 99%

Chapter 5: Minimal-change disease in adults

2012

Kidney International Supplements

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“…Minimal Change Nephropathy (MCN) with nephrotic syndrome: As the Cochrane review by Palmer et al [7] was inconclusive with respect to the treatment of adults due to a lack of clinical studies, recommendations were deducted from one cited adult study [8] and analogous recommendations given in Cochrane Reviews for the treatment of children [9][10][11]. Patients received 1 mg/kgBW/ day of oral prednisolone for 4 -6 weeks.…”

Section: Therapymentioning

confidence: 99%

Evidence-Based Therapy May Improve Outcome in Glomerulonephritis—A Prospective Field Survey

Braun¹,

Schweisfurth²,

Gröne³

et al. 2012

OJNeph

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Introduction and Aims: Although glomerulonephritis is rare in the general population it is the second most important cause for end-stage renal failure. The therapy of glomerulonephritis is guided by a limited number of individual clinical trials and treatment recommendations are based on meta-analysis and Cochrane Systematic Reviews. The impact of such therapy standards on the prognosis of glomerulonephritis is not known. Methods: Between October 2002 and December 2008 patients with abnormal urine findings and/or decreasing renal function of unknown cause were referred for renal biopsy. In a collaboration of outpatient nephrologists with a major teaching hospital, all patients received treatment recommendations according to evidence-based therapy guidelines based on Cochrane Systematic Reviews. Patient charts were systematically reviewed and patients were reexamined for follow-up until November 2009. Cox Regression analysis was performed to identify independent prognostic factors. Results: Two hundred patients with primary or secondary glomerulonephritis were identified. Complete follow-up data were available from 196 patients with 324 therapeutic interventions. The mean follow-up was 2.8 ± 2.0 years. Among all patients, 37% remained unchanged ill, 13% died, 17% had progressing renal disease, while 19% had a complete and 14% a partial remission. Proteinuria declined in primary glomerulonephritis (5.0 ± 5.4 g/d to 2.1 ± 3.4 g/d, p < 0.001) and secondary glomerulonephritis (4.8 ± 4.6 g/d to 2.7 ± 3.1 g/d, p = 0.004). The highest rates of remission were observed in minimal change disease (83%) and membranous nephropathy (50%). Survival was lowest in MPGN and secondary rapid-progressive glomerulonephritis (33% and 50%, respectively). 70 (22%) interventions were complicated by adverse events resulting in treatment cessation in 25 cases. Cox univariate analyses identified the following parameters to improve outcome: Histology, no tubulointerstitial fibrosis, primary glomerulopathy, absence of hypertension at presentation, diabetes, ischemic heart disease, no diuretics or insulin, serum creatinine < 175 µmol/l, blood pressure < 160 mmHg, age < 60 ys, prednisolone, cyclosporin A, azathioprine, and follow-up by 24 hr urine. In a multivariate forward Cox regression analysis, tubulo-interstitial fibrosis had a hazard for the combined end-point of death, dialysis and progression of renal failure of 4.4 (95% confidence interval (95% CI: 1.8-10.6) while intensive follow-up by regular 24 hr urine collections reduced the risk to 0.3 (95% CI: 0.1-0.7), treatment with prednisolone had a hazard of 0.3 (95% CI: 0.1-0.9), and cyclosporin A therapy a hazard of 0.2 (95% CI: 0.02-1.4). Application of Cochrane review based therapy guidelines along with intensified monitoring of renal function prolonged dialysis-free survival by 1.7 years. Conclusions: In a multivariate model of standardised glomerulonephritis therapy the presence of tubulointerstitial fibrosis was associated with death or progresssive renal disease, while prednisolone-ba...

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Interventions for minimal change disease in adults with nephrotic syndrome

Abstract: Analysis 2.2. Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 2 Sustained remission during follow-up....... Analysis 2.3. Comparison 2 Intravenous + oral steroid versus oral steroid, Outcome 3 All-cause mortality.

Cited by 33 publications

References 61 publications

Glomerular disease search filters for Pubmed, Ovid Medline, and Embase: a development and validation study

Glomerular disease search filters for Pubmed, Ovid Medline, and Embase: a development and validation study

Chapter 5: Minimal-change disease in adults

Evidence-Based Therapy May Improve Outcome in Glomerulonephritis—A Prospective Field Survey

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