Definitions for the levels of evidence (I–IV) can be found at the end of the "Major Recommendations" field.
Guidelines
There is limited evidence to suggest that the progression of certain forms of renal disease are retarded by ibopamine. (Level II evidence; single randomized controlled trial (RCT) with suboptimal design; clinically relevant outcome; moderately strong effect) However, this benefit is outweighed by the serious side-effects of ibopamine (3-fold increased risk of death), and its use cannot be recommended.
Suggestions for Clinical Care
(Suggestions based on level III and IV sources)
There is limited evidence to suggest that the progression of certain forms of renal disease is retarded by non-steroidal anti-inflammatory drugs (NSAIDs) (Level III evidence; several retrospective and prospective cohort studies; mostly surrogate outcome measures; consistent weak effect) and by combined ketoconazole and prednisone (Level II–III evidence; single small cross-over study; clinically relevant outcome; weak effect). However, these benefits are outweighed by the serious side-effects of these medications, and their use cannot be currently recommended.
Definitions:
Levels of Evidence
Level I: Evidence obtained from a systematic review of all relevant randomized controlled trials (RCTs)
Level II: Evidence obtained from at least one properly designed RCT
Level III: Evidence obtained from well-designed pseudo-randomized controlled trials (alternate allocation or some other method); comparative studies with concurrent controls and allocation not randomized, cohort studies, case-control studies, interrupted time series with a control group; comparative studies with historical control, two or more single arm studies, interrupted time series without a parallel control group
Level IV: Evidence obtained from case series, either post-test or pretest/post-test
