REVIEW PAPER
Does corticosteroid treatment affect the progression of pediatric IgA nephropathy – a systematic review and meta-analysis
1
Faculty of Medicine, Universitas Yarsi, Jakarta, Indonesia
2
Faculty of Medicine, Universitas Tarumanagara, Jakarta, Indonesia
3
Faculty of Medicine, Universitas Kristen Indonesia, Java, Indonesia
4
Faculty of Medicine, Universitas Brawijaya, Java, Indonesia
5
Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah, Banten, Indonesia
6
Faculty of Medicine, Universitas Jember, Jember, Indonesia
7
Departement of Internal Medicine, Dr. Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
These authors had equal contribution to this work
Submission date: 2024-09-27
Final revision date: 2025-01-28
Acceptance date: 2025-01-30
Publication date: 2025-03-14
Pediatr Pol 2025;61(1):74-85
KEYWORDS
TOPICS
ABSTRACT
Immunoglobulin A nephropathy (IgAN) is an autoimmune disease in pediatric patients, with corticosteroid (CS) treatment remaining controversial. This meta-analysis evaluates the efficacy and safety of CS in pediatric IgAN patients. A systematic search of PubMed, ProQuest, and Wiley identified six studies with 208 patients. Outcomes included estimated glomerular filtration rate (eGFR), events of renal insufficiency, end-stage renal disease (ESRD), proteinuria, hematuria, IgA deposits, and side effects. Corticosteroid treatment showed a significant increase in eGFR (mean differences – MD: 11.84 [0.73–22.95] ml/min/1.73 m2), lower odds of having ESRD (odds ratios – OR: 0.21 [0.05–0.94]) and heavy proteinuria (OR: 0.15 [0.04–0.57]), and significant reduction in dipstick hematuria (MD: 2.89 [–3.85 to –1.93]). However, IgA deposits persisted despite CS treatment. Corticosteroid side effects were minimal. Corticosteroids may reduce glomerular damage and preserve renal function in pediatric IgAN patients, but limitations in addressing IgA deposits suggest the need for additional therapies.
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