New vistas in transplantationRenal transplantationSirolimus for Treatment of Autosomal-Dominant Polycystic Kidney Disease: A Meta-Analysis of Randomized Controlled Trials
Section snippets
Literature Search and Screen
A comprehensive literature search was undertaken using PUBMED, EMBASE, and Cochrane Library up to March 2013. Search terms including medical subject heading words and text words were related to exposure (Table 1). No publication year or publication language restrictions were applied. References of the identified relevant studies were scrutinized. RCTs of ADPKD patients with GFR >30 mL/min/1.73 m2 treated with sirolimus compared with conventional or placebo treatment were included. We excluded
Literature Search and Characteristics of Studies
A total of 4 RCTs [7], [8], [9], [10] fulfilled eligibility criteria extracted from 92 potentially relevant articles. The detailed steps were in the flow diagram for meta-analysis presented in Figure 1. Characteristics of included RCTs are presented in Table 2. There are 183 early-stage ADPKD patients included in these 4 RCTs. Length of follow-up ranged from 6 to 24 months.
Study Quality
Risk of bias was accessed through a domain-based evaluation tool recommended by the Cochrane Collaboration, which includes
Discussion
With the increasing understanding of the links between the molecular mechanisms of ADPKD and the mTOR signaling pathway, mTOR inhibiters, especially sirolimus, have become a focus of attention in novel therapies for ADPKD. Of 24 interventional trials for ADPKD currently registered with clinicaltrials.gov, 8 studies are about mTOR inhibiters [11]. The aim of this meta-analysis was to determine whether sirolimus could slow the progression of ADPKD and preserve the patients' renal function.
ADPKD
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Cited by (0)
Y.-M.L. and Y.S. contributed equally to this work as co-first authors.