Efficacy of paricalcitol on eGFR and proteinuria in non-dialysis CKD patients: a meta-analysis / 中华肾脏病杂志

ABSTRACT

Objective To systematic evaluate the efficacy of paricalcitol on estimated glomerular filtration rate (eGFR) and proteinuria in non-dialysis chronic kidney disease (CKD) patients.Methods According to the collaborative search strategy,PubMed,the clinical control test database of Cochrane Library,Embase,Chinese Wanfang database,CNKI,VIP database (form the date of database establishment to March 2014) were searched.Published and unpublished literature,abstracts in academic meetings (ASN,WCN,CSN) were also searched by hand.The randomized controlled trials (RCTs) about the efficacy paricalcitol on eGFR and proteinuria in non-dialysis CKD patients were selected.Review Manager Software 5.2 was used for statistical analysis.Results Seven RCTs with a total of 834 patients were included (508 in experimental group,326 in placebo group).No statistical difference of the efficacy on eGFR[SMD=-0.10,95％ CI(-0.28-0.07),P=0.26] between lower dose paricalcitol (＜ 2 μg/d) group and placebo group,while higher dose (2 μg/d) group reduced eGFR significantly [SMD=-0.45,95％ CI(-0.63--0.27),P ＜ 0.01].Compared with placebo,paricalcitol reduced proteinuria significantly [OR(95％C1)2.09(1.52-2.58),P ＜ 0.01],and there was no difference between different dose groups [OR(95％CI)1.09(0.62-1.91),P=0.77].Lower dose group [OR(95％C1)0.93(0.57-1.52),P=0.76] and higher dose group [OR(95％ CI)2.08(0.70-6.18),P=0.19] did not significantly increase the risk of adverse events.Conclusions Lower dose paricalcitol (＜ 2 μg/d)has no effect on eGFR in non-dialysis CKD patients meanwhile reduces proteinuria.The higher dose (2μg/d) may reduce eGFR without farther reduction in proteinuria.