PMID- 24022660
OWN - NLM
STAT- MEDLINE
DCOM- 20140808
LR  - 20220309
IS  - 1660-2110 (Electronic)
IS  - 1660-2110 (Linking)
VI  - 124
IP  - 1-2
DP  - 2013
TI  - Long-term treatment with mammalian target of rapamycin inhibitor does not benefit 
      patients with autosomal dominant polycystic kidney disease: a meta-analysis.
PG  - 10-6
LID - 10.1159/000354398 [doi]
AB  - BACKGROUND: The role of the mammalian target of rapamycin (mTOR) inhibition in 
      the treatment of autosomal dominant polycystic kidney disease (ADPKD) remains 
      unclear. This meta-analysis included all randomized controlled trials (RCTs) that 
      used mTOR inhibitors (TORIs) to halt the progression of ADPKD. METHODS: Databases 
      including MEDLINE, EMBASE, and the Cochrane Library were searched to find 
      relevant trials. RCTs of TORI treatment in patients with ADPKD were included. 
      Effects on the primary outcome [total kidney volume (TKV)] and secondary outcomes 
      [changes in cyst volume (CV) and parenchymal volume (PV), glomerular filtration 
      rate (GFR), proteinuria, and adverse events] were analyzed. RESULTS: The results 
      of 5 RCTs, which included 619 patients, were analyzed. TORIs did not 
      significantly reduce TKV [mean difference (WMD) -90.01 ml, 95% CI -235.49 to 
      55.47, p = 0.23; I(2) = 0%; p for heterogeneity = 0.67]. CV decreased after TORI 
      treatment (WMD -15.08 ml, 95% CI -17.82 to -12.34, p < 0.00001), and PV did not 
      change (WMD -0.55 ml, 95% CI -64.55 to 63.45, p = 0.99). There was no significant 
      difference in GFR between the TORI-treated and control groups (WMD 4.94 ml/min, 
      95% CI -0.81 to 10.68, p = 0.09). Proteinuria was significantly higher in the 
      TORI-treated group than in the control group (standard mean difference 0.27, 95% 
      CI 0.09-0.44, p = 0.002). CONCLUSION: Long-term treatment with TORIs does not 
      benefit patients with ADPKD.
CI  - (c) 2013 S. Karger AG, Basel.
FAU - Xue, Cheng
AU  - Xue C
AD  - Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical 
      University, Shanghai, China.
FAU - Dai, Bing
AU  - Dai B
FAU - Mei, Changlin
AU  - Mei C
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20130906
PL  - Switzerland
TA  - Nephron Clin Pract
JT  - Nephron. Clinical practice
JID - 101159763
RN  - 0 (Immunosuppressive Agents)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Evidence-Based Medicine
MH  - Humans
MH  - Immunosuppressive Agents/adverse effects/therapeutic use
MH  - Longitudinal Studies
MH  - Polycystic Kidney, Autosomal Dominant/*drug therapy/*prevention & control
MH  - Proteinuria/*chemically induced/prevention & control
MH  - Sirolimus/*adverse effects/*therapeutic use
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
MH  - Treatment Outcome
EDAT- 2013/09/12 06:00
MHDA- 2014/08/13 06:00
CRDT- 2013/09/12 06:00
PHST- 2012/12/07 00:00 [received]
PHST- 2013/06/27 00:00 [accepted]
PHST- 2013/09/12 06:00 [entrez]
PHST- 2013/09/12 06:00 [pubmed]
PHST- 2014/08/13 06:00 [medline]
AID - 000354398 [pii]
AID - 10.1159/000354398 [doi]
PST - ppublish
SO  - Nephron Clin Pract. 2013;124(1-2):10-6. doi: 10.1159/000354398. Epub 2013 Sep 6.