Efficacy of Glucocorticoids and Glucocorticoid-Induced Hyperglycaemia in Renal Disease: A Meta-Analysis of Randomized Controlled Trials

Comput Math Methods Med. 2022 Mar 7:2022:2484626. doi: 10.1155/2022/2484626. eCollection 2022.

Abstract

Background: Glucocorticoids are the most effective anti-inflammatory and immunosuppressive drugs used to treat patients with renal disease. This study pooled the current evidence of the efficacy of Glucocorticoids and Glucocorticoid-induced hyperglycaemia in renal disease.

Methods: We conducted a systematic literature search on PubMed, Cochrane Central, and Web of Science for relevant randomized controlled trials (RCTs) up to September 1, 2021. The meta-analysis, sensitivity analysis and bias analysis were performed using Review Manager 5. 3.

Results: In this study, seven RCTs with 797 patients were included in our analysis. The analysis revealed that glucocorticoids had a certain alleviating effect on the reduction of renal function. (risk ratio [RR] 0.49 95% confidence interval [Cl] 0. 28 to 0.85, p =0.01) and reduction of proteinuria (weight mean difference [WMD] -0.43; 95% CI -0.57 to-0.28) when compared with the control group. Patients receiving glucocorticoids therapy did not have an increased risk of developing new-onset diabetes mellitus or impaired glucose tolerance. (RR 3.76 95% CI 0.54 to 26.10, p =0.18). For other safety outcomes, glucocorticoids therapy did not increase risk of respiratory infections (RR 1.63, 95% CI 0. 69to3. 89, p =0.27) and Gastrointestinal SAEs is relatively controversial (RR 1.10, 95% CI 0.32 to 3.79, p =0.88). Discussion. In conclusion, current clinical evidence indicates that glucocorticoids is efficacious and safe to renal disease compared with control. Further research comparing long-term glucocorticoids use is needed.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Retracted Publication

MeSH terms

  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Computational Biology
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use*
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / chemically induced*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Kidney Diseases / drug therapy*
  • Kidney Diseases / physiopathology
  • Kidney Function Tests
  • Proteinuria / drug therapy
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Safety

Substances

  • Anti-Inflammatory Agents
  • Blood Glucose
  • Glucocorticoids
  • Immunosuppressive Agents