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Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria
BACKGROUND: Medical intervention for patients with IgA nephropathy and mild proteinuria (<1.0 g/day) is controversial, and the effectiveness of tonsillectomy plus steroid pulse therapy (TSP) for such patients remains obscure. METHODS: Among 323 patients in our multicenter cohort study, 79 who had...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Japan
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756031/ https://www.ncbi.nlm.nih.gov/pubmed/26123429 http://dx.doi.org/10.1007/s10157-015-1138-7 |
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author | Komatsu, Hiroyuki Sato, Yuji Miyamoto, Tetsu Tamura, Masahito Nakata, Takeshi Tomo, Tadashi Nishino, Tomoya Miyazaki, Masanobu Fujimoto, Shouichi |
author_facet | Komatsu, Hiroyuki Sato, Yuji Miyamoto, Tetsu Tamura, Masahito Nakata, Takeshi Tomo, Tadashi Nishino, Tomoya Miyazaki, Masanobu Fujimoto, Shouichi |
author_sort | Komatsu, Hiroyuki |
collection | PubMed |
description | BACKGROUND: Medical intervention for patients with IgA nephropathy and mild proteinuria (<1.0 g/day) is controversial, and the effectiveness of tonsillectomy plus steroid pulse therapy (TSP) for such patients remains obscure. METHODS: Among 323 patients in our multicenter cohort study, 79 who had mild proteinuria (0.4–1.0 g/day) at diagnosis were eligible to participate in this study. We compared the clinicopathological findings at diagnosis, a decline in renal function defined as a 50 or 100 % increase in serum creatinine (sCr) and clinical remission (CR) defined as the disappearance of hematuria and proteinuria (<0.3 g/day) among groups given TSP (n = 46), steroid therapy (ST) (n = 9), and non-ST (n = 24). Factors contributing to CR were also evaluated using multivariate analysis. RESULTS: Background factors at diagnosis including age, ratio (%) of patients with hypertension, sCr, proteinuria, and histological severity did not significantly differ among the groups. Only two patients each in the TSP (4.3 %) and non-ST (8.3 %) groups achieved a 50 % increase in sCr during a mean follow–up period of 4.7 years. At the final observation, 71.7, 44.4, and 41.7 % of patients in the TSP, ST, and non-ST groups, respectively, achieved CR (p = 0.032). Cox proportional hazards models revealed that TSP led to CR more effectively than non-TSP by a factor of about threefold (hazard ratio, 2.74; p = 0.008). CONCLUSION: TSP therapy has potential for inducing CR in patients with IgAN and mild proteinuria (<1.0 g/day). |
format | Online Article Text |
id | pubmed-4756031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Japan |
record_format | MEDLINE/PubMed |
spelling | pubmed-47560312016-02-26 Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria Komatsu, Hiroyuki Sato, Yuji Miyamoto, Tetsu Tamura, Masahito Nakata, Takeshi Tomo, Tadashi Nishino, Tomoya Miyazaki, Masanobu Fujimoto, Shouichi Clin Exp Nephrol Original Article BACKGROUND: Medical intervention for patients with IgA nephropathy and mild proteinuria (<1.0 g/day) is controversial, and the effectiveness of tonsillectomy plus steroid pulse therapy (TSP) for such patients remains obscure. METHODS: Among 323 patients in our multicenter cohort study, 79 who had mild proteinuria (0.4–1.0 g/day) at diagnosis were eligible to participate in this study. We compared the clinicopathological findings at diagnosis, a decline in renal function defined as a 50 or 100 % increase in serum creatinine (sCr) and clinical remission (CR) defined as the disappearance of hematuria and proteinuria (<0.3 g/day) among groups given TSP (n = 46), steroid therapy (ST) (n = 9), and non-ST (n = 24). Factors contributing to CR were also evaluated using multivariate analysis. RESULTS: Background factors at diagnosis including age, ratio (%) of patients with hypertension, sCr, proteinuria, and histological severity did not significantly differ among the groups. Only two patients each in the TSP (4.3 %) and non-ST (8.3 %) groups achieved a 50 % increase in sCr during a mean follow–up period of 4.7 years. At the final observation, 71.7, 44.4, and 41.7 % of patients in the TSP, ST, and non-ST groups, respectively, achieved CR (p = 0.032). Cox proportional hazards models revealed that TSP led to CR more effectively than non-TSP by a factor of about threefold (hazard ratio, 2.74; p = 0.008). CONCLUSION: TSP therapy has potential for inducing CR in patients with IgAN and mild proteinuria (<1.0 g/day). Springer Japan 2015-06-30 2016 /pmc/articles/PMC4756031/ /pubmed/26123429 http://dx.doi.org/10.1007/s10157-015-1138-7 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Komatsu, Hiroyuki Sato, Yuji Miyamoto, Tetsu Tamura, Masahito Nakata, Takeshi Tomo, Tadashi Nishino, Tomoya Miyazaki, Masanobu Fujimoto, Shouichi Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria |
title | Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria |
title_full | Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria |
title_fullStr | Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria |
title_full_unstemmed | Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria |
title_short | Significance of tonsillectomy combined with steroid pulse therapy for IgA nephropathy with mild proteinuria |
title_sort | significance of tonsillectomy combined with steroid pulse therapy for iga nephropathy with mild proteinuria |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756031/ https://www.ncbi.nlm.nih.gov/pubmed/26123429 http://dx.doi.org/10.1007/s10157-015-1138-7 |
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