Immunosuppressant Use in Infective Endocarditis-Associated Glomerulonephritis: A Systematic Review
Abstract
Background: Patients with infective endocarditis can develop various renal diseases, including infective endocarditis-associated glomerulonephritis. Antibiotics are essential for eradicating the infection. However, the prognosis for renal function remains poor. This systematic review examines the role of immunosuppressants in managing infective endocarditis-associated glomerulonephritis (GN).
Methods: A comprehensive search was performed across four databases: PubMed, Scopus, MedLine, and Web of Science up to April 2024. We included studies that investigated patients with any type of GN due to infective endocarditis (IE) who were treated with immunosuppressants. Data extraction was conducted using a standardized sheet, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool.
Results: The review incorporated 55 studies encompassing 84 cases, 65 of whom were male. The median age was 46.5 years. A total of 30 cases required kidney replacement therapy. Following immunosuppressive therapy, clinical improvement of IE was observed in 54 cases, while 9 patients experienced worsening conditions, 3 patients had no clinical change, and data were unavailable in 18 cases. Renal outcomes showed improvement in 67 patients, with 9 cases showing worsening conditions, 3 patients showing no change, 3 experiencing partial or residual impairment, and renal outcome was unavailable in 2 cases. A total of ten patients died, primarily owing to sepsis or…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 67 participants or records.
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