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A collection of symptoms that indicate kidney damage. Symptoms include high levels of protein in the urine, lack of protein in the blood, and high blood cholesterol.

Results: 1 to 20 of 45

Tripterygium wilfordii Hook F treatment for idiopathic refractory nephrotic syndrome in adults: a meta-analysis

This review assessed Tripterygium wilfordii Hook F (TwHF) efficacy compared with placebo or cyclophosphamide for treating idiopathic refractory nephrotic syndrome in terms of recovery rate. The authors concluded that TwHF showed a beneficial effect, but studies with larger sample sizes of patients with mild and severe histopathological change were warranted. These conclusions reliably reflect the very limited evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Astragalus in the prevention of upper respiratory tract infection in children with nephrotic syndrome: evidence-based clinical practice

Aims. To explore whether Astragalus or its formulations could prevent upper respiratory infection in children with nephrotic syndrome and how best to use it. Methods. We transformed a common clinical question in practice to an answerable question according to the PICO principle. Databases, including the Cochrane Library (Issue 5, 2012), PUBMED (1966-2012.8), CBM (1978-2012.8), VIP (1989-2012.8), and CNKI (1979-2012.8), were searched to identify Cochrane systematic reviews and clinical trials. Then, the quality of and recommendations from the clinical evidence were evaluated using the GRADEpro software. Results. The search yielded 537 papers. Only two studies with high validity were included for synthesis calculations. The results showed that Astragalus granules could effectively reduce URTI in children with nephrotic syndrome compared with prednisone treatment alone (23.9% versus 42.9%; RR = 0.56 and 95% CI = 0.33-0.93). The dose of Astragalus granules was 2.25 gram (equivalent to 15 gram crude Astragalus) twice per day, at least for 3-6 months. The level of evidence quality was low, but we still recommended the evidence to the patient according to GRADEpro with the opinion of the expert. Followup showed the incidence of URTI in this child decreased significantly. Conclusions. Astragalus granules may reduce the incidence of URTI in children with nephrotic syndrome.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Deflazacort in comparison to other steroids for nephrotic syndrome

Patients with nephrotic syndrome require steroids for long time and sometimes repeatedly resulting in various adverse effects. Deflazacort (DFZ) had been described as equally effective and with fewer side effects as compared with other steroids. This review evaluates the literature on efficacy and toxicity of DFZ as compared with other therapies for nephrotic syndrome. A systematic review of Pubmed database and Cochrane Central Register of Controlled Trials with last search date of 20(th) April 2011. Search terms included "nephrotic AND deflazacort" without any limitations. Randomized control trials comparing DFZ vs placebo or other therapies in subjects with nephrotic syndrome were included. Two authors extracted data independently. Three studies meet inclusion criteria and data were synthesized qualitatively. The limited evidence suggested that DFZ appeared to be equally effective in inducing remission or decreasing proteinuria in patients with nephrotic syndrome. It caused significantly less decrease in bone mineral content (BMC) in spine as compared with prednisolone. The results related to weight change, blood pressure change, Cushingoid symptoms, and urinary calcium excretion were inconsistent between included studies. By reviewing the available limited evidence, DFZ appears to be of similar efficacy for nephrotic patients, but there were inconsistent results regarding side effect profile of DFZ as compared with other steroids except for decrease in BMC where DFZ was better. There is need for larger randomized controlled trials to evaluate effectiveness and adverse effect profile of DFZ as compared with other steroids in nephrotic syndrome.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

[Efficacy and safety of cyclosporine A in treatment of refractory nephrotic syndrome in children: a systematic review of randomized controlled trials]

OBJECTIVE: To evaluate the efficacy and safety of cyclosporine A(CsA) in the treatment of refractory nephrotic syndrome (RNS) in children.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Cyclosporin may increase the number of children who achieve complete remission in steroid‐resistant nephrotic syndrome. Angiotensin converting enzyme (ACE) inhibitors significantly reduce the degree of proteinuria

Nephrotic syndrome is a condition where the kidneys leak protein from the blood into the urine. Corticosteroids are used in the first instance to achieve remission. Some children do not respond to this treatment and other agents such as cyclophosphamide, chlorambucil, cyclosporin or ACE inhibitors may be used. This review found that when cyclosporin was compared to placebo or no treatment there was a significant increase in the number of children who achieved complete remission. Cyclosporin also significantly increased the number of children, who achieved complete or partial remission compared with IV cyclophosphamide. There was no improvement with other immunosuppressive agents. However the number of studies was small. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Interventions for minimal change disease in adults with nephrotic syndrome

Nephrotic syndrome is a condition where the kidneys leak protein from the blood into the urine. Minimal change disease is the third most common primary kidney disease in adults with unexplained nephrotic syndrome (10% to 15%). Steroids have been used widely since the early 1970s for the treatment of adult‐onset minimal change disease, however the optimal agent, dose and duration has not been determined. This review identified three small studies (68 participants) comparing: 1) intravenous plus oral steroid treatment versus oral sterids; 2) oral versus short‐course intravenous steroid treatment; and 3) oral steroid treatment versus placebo. Only oral steroid treatment (compared to short‐course intravenous steroid treatment) showed an increase in the number of patients who achieved complete remission. However, the lack of available studies leaves important treatment questions unanswered; what is the optimal dose and duration of steroid treatment in new‐onset adult minimal change disease; how are relapses following steroid‐induced remission prevented and treated; and what are the appropriate treatments for steroid‐dependent or treatment‐resistant minimal change disease?

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Non‐corticosteroid treatment for nephrotic syndrome in children

Children with nephrotic syndrome lose excessive amounts of protein from their bloodstream into their urine, causing swelling, especially in the face, stomach and legs. The risk of infection also increases because important proteins used by children's immune systems have been lost. Corticosteroid drugs, such as prednisone, can stop protein loss, but often happens again (relapse). Giving children further corticosteroids can lead to poor growth, cataracts, osteoporosis and high blood pressure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Chinese herbal medicine Huangqi type formulations for nephrotic syndrome

Heavy proteinuria (protein in the urine), hypoalbuminaemia (low blood albumin levels), oedema (a build‐up of fluid, resulting in swelling) and hypercholesterolaemia (high blood cholesterol) are the major characteristics of nephrotic syndrome. At present, the primary drugs for nephrotic syndrome are corticosteroids, alkylating agents and cyclosporin. However there are many adverse effects associated with their use. This review identified nine studies (461 participants) comparing Huangqi type formulations with control drugs. The results of this review suggest that Huangqi type formulations may have a positive effect on nephrotic syndrome by increasing plasma albumin and reducing urine albumin excretion, blood cholesterol and triglycerides. Huangqi type formulation may reduce some adverse effects of other drugs used for treating nephrotic syndrome, however these were only reported in two studies. The methodological quality of the nine included studies was poor and was the major limitation of this review. The types of pathology, sex and age of the patients, as well as the duration and dosage of the Huangqi type formulations could not be analysed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

No strong evidence for any interventions for preventing infection in nephrotic syndrome

Patients with nephrotic syndrome, particularly children, are susceptible to infections. Infections can cause frequent relapses of illness, poor response to therapies (e.g. steroids) and severe infections occasionally lead to death. Oral antibiotics, pneumococcal vaccination, some immunomodulators and Chinese medicinal herbs have been used/recommended for reducing the risk of infection. No studies on antibiotics, pneumococcal vaccination and any other non‐drug prophylaxis were identified. This review found that intravenous immunoglobulin (IVIG), thymosin, oral transfer factor, Bacillus Calmette‐Guerin (BCG) vaccine injection and two kinds of Chinese medicinal herbs (Huangqi granules and TIAOJINING) may help prevent infections in nephrotic children. These studies were methodologically poor. Currently there is no strong evidence for recommending any interventions for preventing infections in nephrotic syndrome. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Tripterygium wilfordii Hook F (a traditional Chinese herbal medicine) for primary nephrotic syndrome

Primary nephrotic syndrome (NS) is a relatively rare kidney disease (diagnosed in up to 7/100,000 children and 3/100,000 adults annually). However the resulting kidney damage causes loss of proteins in urine (proteinuria) leading to low level albumin in the bloodstream, which can cause raised lipids and severe, generalised swelling. Primary NS can also lead to blood clotting (thromboembolism), infection, and acute kidney injury, and may become life threatening. Treatment for primary NS aims to relieve symptoms, avoid complications, and prolong life. Immunosuppressive treatments are of importance for primary NS. In China, a traditional Chinese herbal medicine, Tripterygium wilfordii Hook F (TwHF) has been used for over two decades as an immunosuppressive agent to decrease proteinuria and preserve kidney function. TwHF is prescribed alone or in combination with corticosteroids or other immunosuppressive agents such as cyclophosphamide (CPA).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Lipid‐lowering agents for nephrotic syndrome

Nephrotic syndrome is a relatively rare disease in which the kidneys leak protein into the urine. A common early sign is swelling in the feet and face. Other signs and symptoms of nephrotic syndrome include low levels of protein in the blood, and high levels of fats in the blood, particularly cholesterol and triglycerides.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Corticosteroid therapy for children with nephrotic syndrome

Nephrotic syndrome is a condition where the kidneys leak protein from the blood into the urine. When it is untreated, children can often die from infections. Most children, with nephrotic syndrome, respond to corticosteroid drugs (prednisone, prednisolone) reducing the risk of serious infection. However they usually have repeat episodes, which are often triggered by viral infections. Corticosteroid drugs can have serious side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Immunosuppressive treatment for idiopathic membranous nephropathy in adults with nephrotic syndrome

Idiopathic membranous nephropathy (IMN) is a disease in which glomerular basement membrane becomes thickening by light microscopy on renal biopsy and it represents a major cause of primary nephrotic syndrome in adults. A combined alkylating agent and corticosteroid regimen had short‐ and long‐term benefits on adult IMN with nephrotic syndrome. Among alkylating agents, cyclophosphamide was safer than chlorambucil. It should be emphasised that the number of included randomised studies with high‐quality design was relatively small and most of the included studies did not have adequate follow‐up and enough power to assess the prespecified outcomes. Meanwhile, this regimen was significantly associated with more withdrawals or hospitalisations. Although a six‐month course of alternating monthly cycles of corticosteroids and cyclophosphamide was recommended by the KDIGO Clinical Practice Guideline 2012 as the initial therapy for adult IMN with nephrotic syndrome, clinicians should inform their patients of the lack of high‐quality evidence for these benefits as well as the well‐recognised adverse effects of this therapy. Whether this combined therapy should be indicated in all adult patients at high risk of progression to ESKD or only restricted to those with deteriorating kidney function still remained unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

The clinical effectiveness and cost-effectiveness of treatments for children with idiopathic steroid-resistant nephrotic syndrome: a systematic review

Nephrotic syndrome is a collection of signs and symptoms, including protein in the urine, low blood protein levels, high cholesterol levels and swelling. First line treatment is with oral corticosteroids, but some children do not respond to this treatment. The optimal treatment of steroid-resistant nephrotic syndrome (SRNS) is uncertain.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2007

Meta-analysis on efficacy of TG and GC for nephritic syndrome

Bibliographic details: Kou C G, Lu X Z, Qi J, Xie B, Yu Y Q.  Meta-analysis on efficacy of TG and GC for nephritic syndrome. Journal of Jilin University (Medicine Edition) 2008; 34(4): 671-675

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Meta-analysis: anti-viral therapy of hepatitis B virus-associated glomerulonephritis

This review evaluated the efficacy and safety of antiviral therapy in chronic hepatitis B virus-associated glomerulonephritis. Antiviral agents induced remission of the proteinuria and a virological response. These agents seemed well tolerated and did not cause serious adverse events. The authors' conclusions should be viewed with caution, owing to the small size and poor quality of the studies included.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Immunosuppressive treatment for nephrotic idiopathic membranous nephropathy: a meta-analysis based on Chinese adults

BACKGROUND: Idiopathic membranous nephropathy (IMN) is the most common pathological type for nephrotic syndrome in adults in western countries and China. The benefits and harms of immunosuppressive treatment in IMN remain controversial.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (Update)

Over 90% of people with diabetes have Type 2 diabetes. This is still perceived as the milder form, and while this may be true in some respects, such as the risk of ketoacidosis, the causation of Type 2 diabetes is more complex and the management is not necessarily easier. Type 2 diabetes can cause severe complications, affecting the eye, the nervous system and the kidney. The overall risk of cardiovascular disease is more than doubled, and life expectancy is reduced by an average 7 years. In 2002, NICE published a suite of five guidelines dealing with different aspects of the care of Type 2 diabetes. The rising prevalence of the disease, and the range of complications which can arise, reinforce the importance of up-to-date guidance and accordingly NICE have asked the National Collaborating Centre for Chronic Conditions (NCC-CC) to produce this guideline, amalgamating and updating the previously published work.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2008
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Drug Class Review: Direct Renin Inhibitors, Angiotensin Converting Enzyme Inhibitors, and Angiotensin II Receptor Blockers: Final Report [Internet]

The renin-angiotensin system is a complex biologic system between the heart, brain, blood vessels, and kidneys that leads to the production of biologically active agents, including angiotensin I and II and aldosterone, which act together to impact a variety of bodily functions including blood vessel tone, sodium balance, and glomerular filtration pressure. The multiple and varied effects of these agents allows the renin-angiotensin system to play a wide role in the pathology of hypertension, cardiovascular health, and renal function. Our ability to begin to intervene upon the complex cycle of hormone and other biochemical agent production within the renin-angiotensin system began with the advent of the first orally active ACE-I (angiotensin converting enzyme inhibitor), captopril, in 1981. AIIRAs (angiotensin II receptor blockers) were developed as an alternative to ACE-I, and block the interaction between angiotensin II and the angiotensin receptor. Losartan, the first commercially available AIIRA, was approved for clinical use in 1995. The goal of this report is to compare the effectiveness and harms between aliskiren and placebo and between AIIRAs and ACEIs in the treatment of diagnosed coronary heart disease, hypertension, left ventricular dysfunction, heart failure, nondiabetic chronic kidney disease, or diabetic nephropathy.

Drug Class Reviews - Oregon Health & Science University.

Version: January 2010
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Drug Class Review: HMG-CoA Reductase Inhibitors (Statins) and Fixed-dose Combination Products Containing a Statin: Final Report Update 5 [Internet]

In the United States, coronary heart disease and cardiovascular disease account for nearly 40% of all deaths each year. Coronary heart disease continues to be the leading cause of mortality and a significant cause of morbidity among North Americans. In 2006, coronary heart disease claimed 607 000 lives, translating into about 1 out of every 5 deaths in the United States. High levels of cholesterol, or hypercholesterolemia, are an important risk factor for coronary heart disease. The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, also known as statins, are the most effective class of drugs for lowering serum low-density lipoprotein cholesterol concentrations. They are first-line agents for patients who require drug therapy to reduce serum low-density lipoprotein cholesterol concentrations. The purpose of this review is to compare the benefits and harms of different statins in adults and children with hypercholesterolemia.

Drug Class Reviews - Oregon Health & Science University.

Version: November 2009
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Systematic Reviews in PubMed

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