What do systematic reviews say?

Probiotics vs antibiotic prophylaxis

The review found no eligible studies for this question.

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antibiotic prophylaxis vs placebo, no treatment or surveillance only

Antibiotic prophylaxis showed no clear difference in resolution of VUR after 1 to 2 years: unit of analysis (children) compared with surveillance or no treatment (low certainty).

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  RR 1.46 [0.71, 2.99]
  3 studies · 262 participants
  Low

Antibiotic prophylaxis vs placebo, no treatment or surveillance only

Antibiotic prophylaxis showed no clear difference in adverse events compared with surveillance or no treatment (moderate certainty).

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  RR 0.94 [0.81, 1.08]
  4 studies · 1056 participants
  Moderate

Antibiotic prophylaxis vs placebo, no treatment or surveillance only

Antibiotic prophylaxis probably leads to higher microbial resistance to prophylactic drug: unit of analysis (UTI) compared with surveillance or no treatment (moderate certainty).

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  RR 2.72 [1.85, 4]
  6 studies · 259 participants
  Moderate

Surgical reimplantation of ureters plus antibiotics vs antibiotics alone

Surgical reimplantation of ureters plus antibiotics showed no clear difference in all symptomatic UTI by 4 to 5 years: surgical correction +… compared with antibiotics alone (moderate certainty).

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  RR 0.95 [0.67, 1.35]
  1 study · 297 participants
  Moderate

Surgical reimplantation of ureters plus antibiotics vs antibiotics alone

Surgical reimplantation of ureters plus antibiotics probably leads to lower febrile UTI by 5 years: surgical correction + antibiotics versus… compared with antibiotics alone (moderate certainty).

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  RR 0.43 [0.27, 0.7]
  2 studies · 429 participants
  Moderate

Surgical reimplantation of ureters plus antibiotics vs antibiotics alone

Surgical reimplantation of ureters plus antibiotics showed no clear difference in repeat positive urine cultures by 4 to 5 years: surgical correction… compared with antibiotics alone (moderate certainty).

• Interventions for primary vesicoureteric reflux 2019 · Cochrane Headline outcomes only
  RR 0.99 [0.79, 1.26]
  3 studies · 479 participants
  Moderate

Cyclosporin vs placebo or no treatment

Cyclosporin may leads to higher complete remission: all renal pathologies compared with placebo or no treatment (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 3.5 [1.09, 11.2]
  4 studies · 74 participants
  Low

Calcineurin inhibitor vs IV cyclophosphamide

It is very uncertain whether calcineurin inhibitor changes treatment response at 3 to 6 months: partial remission compared with IV cyclophosphamide (very low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 1.68 [0.43, 6.56]
  2 studies · 156 participants
  Very low

Calcineurin inhibitor vs IV cyclophosphamide

Calcineurin inhibitor probably leads to lower adverse events: treatment failure at 6 months (non response, serious… compared with IV cyclophosphamide (moderate certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.32 [0.18, 0.58]
  1 study · 124 participants
  Moderate

Calcineurin inhibitor vs IV cyclophosphamide

Calcineurin inhibitor probably leads to lower adverse events: medications ceased due to adverse events compared with IV cyclophosphamide (moderate certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.2 [0.04, 0.86]
  1 study · 131 participants
  Moderate

Calcineurin inhibitor vs IV cyclophosphamide

Calcineurin inhibitor showed no clear difference in adverse events: serious infections compared with IV cyclophosphamide (moderate certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.49 [0.16, 1.56]
  1 study · 131 participants
  Moderate

Calcineurin inhibitor vs IV cyclophosphamide

Calcineurin inhibitor showed no clear difference in adverse events: death compared with IV cyclophosphamide (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.33 [0.01, 7.92]
  1 study · 131 participants
  Low

Tacrolimus vs cyclosporin

Tacrolimus showed no clear difference in treatment response at 6 months: complete remission compared with cyclosporin (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 1.14 [0.64, 2.03]
  1 study · 41 participants
  Low

Tacrolimus vs cyclosporin

Tacrolimus showed no clear difference in treatment response at 6 months: complete and partial remission compared with cyclosporin (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.57 [0.16, 2.08]
  1 study · 41 participants
  Low
• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 1.05 [0.87, 1.25]
  2 studies · 58 participants
  Low

Tacrolimus vs cyclosporin

Tacrolimus showed no clear difference in treatment response at 12 months: complete remission compared with cyclosporin (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.8 [0.45, 1.42]
  2 studies · 58 participants
  Low

Tacrolimus vs cyclosporin

Tacrolimus showed no clear difference in adverse events: persistent nephrotoxicity compared with cyclosporin (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.48 [0.05, 4.85]
  1 study · 41 participants
  Low

Cyclosporin vs placebo or no treatment

Cyclosporin showed no clear difference in complete remission: FSGS compared with placebo or no treatment (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 3.14 [0.97, 10.18]
  3 studies · 58 participants
  Low

Tacrolimus vs cyclosporin

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 58 participants
  Low

Cyclosporin vs mycophenolate mofetil with pulse dexamethasone

Cyclosporin showed no clear difference in treatment response at 52 weeks: complete remission (primary outcome… compared with mycophenolate mofetil with pulse dexamethasone (moderate certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 2.14 [0.87, 5.24]
  1 study · 138 participants
  Moderate