Evidence map›Paper›PMID 36840902›Full record

ArticleClinical and experimental nephrology2023

Initiation of renin-angiotensin system inhibitors and first complete remission in patients with primary nephrotic syndrome: a nationwide cohort study.

Sayaka Shimizu, Kakuya Niihata, Hiroki Nishiwaki, Yugo Shibagaki, Ryohei Yamamoto, Kosaku Nitta, Tatsuo Tsukamoto, Shunya Uchida, Asami Takeda, Hirokazu Okada and 4 more

Abstract read
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In one paragraph

Article in Clinical and experimental nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 50% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 11 institutions in 1 country.

Sayaka Shimizu *Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan.
Kakuya Niihata *Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, 960-1295, Japan.
Hiroki Nishiwaki *Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, 960-1295, Japan.
Yugo ShibagakiDepartment of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Ryohei YamamotoHealth and Counseling Center, Osaka University, Toyonaka, Osaka, Japan.
Kosaku NittaDepartment of Medicine, Tokyo Women's Medical University, Kidney Center, Shinjuku, Tokyo, Japan.
Tatsuo TsukamotoDivision of Nephrology and Dialysis, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Shunya UchidaDepartment of Internal Medicine, Teikyo University School of Medicine, Itabashi, Tokyo, Japan.
Asami TakedaKidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, Japan.
Hirokazu OkadaDepartment of Nephrology, Saitama Medical University, Moroyama Town, Saitama, Japan.
Ichiei NaritaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Yoshitaka IsakaDepartment of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Noriaki KuritaDepartment of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, 960-1295, Japan. kuritanoriaki@gmail.com.ORCID http://orcid.org/0000-0003-4127-7500
Japan Nephrotic Syndrome Cohort Study Group
The University of Osaka · JPFukushima Medical University · JPJapanese Red Cross Nagoya Daini Hospital · JPSaitama Medical University · JPKitano Hospital · JPNiigata University · JPShowa University · JPSt. Marianna University School of Medicine · JPTeikyo University · JPTokyo Women's Medical University · JPFukushima Medical University Hospital · JP

Funding

Ministry of Health, Labour and Welfare 20316943
6 · The paper itself

Abstract

backgroundEvidence on renin-angiotensin system inhibitors (RASis) effect in reducing urinary protein levels in patients with nephrotic syndrome is insufficient. We determined whether RASis can induce complete remission (CR) in patients on immunosuppressive therapy.

methodsThis cohort study included 84 adults (median age, 65 years; males, 57%) with primary nephrotic syndrome (excluding minimal change disease) not receiving RASis during enrollment in the Japanese Nephrotic Syndrome Cohort Study from January 2009 to December 2010, and were followed up for 5 years. Exposure and outcome were RASi initiation and first CR, respectively. Marginal structural models and Poisson regression were used to account for time-varying covariates and estimate causal effects of RASis on CR.

resultsOverall, 51 (61%), 73 (87%), and 55 (66%) patients had membranous nephropathy, were prescribed immunosuppressive agents at baseline (1-month post-renal biopsy and/or at start of immunosuppressive therapy), and were prescribed RASis during the study period, respectively. Sixty-five patients experienced first CR (incidence rate, 5.05/100 person-months). RASi use was associated with a higher (adjusted incidence rate ratio [aIRR] 2.27, 95% confidence interval [CI] 1.06-4.84), and lower (aIRR: 0.17, 95% CI 0.04-0.68) first CR in patients with membranous nephropathy and other pathologies, respectively.

conclusionRASis are beneficial as adjuvant therapy for inducing remission in patients with membranous nephropathy.

Indexed as

Glomerulonephritis, MembranousNephrotic SyndromeAdultAgedAntihypertensive AgentsCohort StudiesEnzyme InhibitorsHumansImmunosuppressive AgentsMaleRenin-Angiotensin SystemAntihypertensive AgentsEnzyme InhibitorsImmunosuppressive AgentsGlomerular diseaseMembranous nephropathyNephrotic syndromeRenin–angiotensin system

Identifiers

PMID36840902
OpenAlexW4321996987

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.