Impact of tonsillectomy combined with steroid pulse therapy on immunoglobulin A nephropathy depending on histological classification: a multicenter study
| العنوان: | Impact of tonsillectomy combined with steroid pulse therapy on immunoglobulin A nephropathy depending on histological classification: a multicenter study |
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| المؤلفون: | Tadashi Tomo, Takashi Nakata, Tomoya Nishino, Ryota Serino, Yutaka Otsuji, Masahito Tamura, Yuji Sato, Kaede Ishida, Tetsu Miyamoto, Shouichi Fujimoto, Masanobu Miyazaki, Tadashi Uramatsu, Nana Ishimatsu, Hiroyuki Komatsu |
| المصدر: | Clinical and Experimental Nephrology. 20:50-57 |
| بيانات النشر: | Springer Science and Business Media LLC, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Adult, Male, Nephrology, medicine.medical_specialty, Pathology, Time Factors, Physiology, Biopsy, medicine.medical_treatment, Kidney Glomerulus, 030232 urology & nephrology, Mesangial hypercellularity, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Severity of Illness Index, Gastroenterology, Nephropathy, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Japan, Physiology (medical), Internal medicine, medicine, Humans, Proportional Hazards Models, Retrospective Studies, Tonsillectomy, Chi-Square Distribution, business.industry, Proportional hazards model, Remission Induction, Hazard ratio, Pathological classification, Glomerulosclerosis, Glomerulonephritis, IGA, Retrospective cohort study, IgA nephropathy, Middle Aged, medicine.disease, Combined Modality Therapy, Treatment Outcome, Pulse Therapy, Drug, Multivariate Analysis, Female, Steroids, business |
| الوصف: | In addition to corticosteroids and inhibition of the renin–angiotensin–aldosterone system, tonsillectomy with steroid pulse therapy (TSP) may have a beneficial impact on the clinical course of IgA nephropathy (IgAN). However, there is still much uncertainty regarding the indications for therapy, treatment protocol, and therapeutic options for IgAN. In this multicenter retrospective cohort study, we enrolled 284 patients with biopsy-proven IgAN who received TSP or corticosteroid therapy or conservative therapy. The effects of TSP on clinical remission (CR) were evaluated after a median follow-up period of 4.1 years in relation to histological classifications. Among the 284 participants, 161 patients received TSP. During the observation time, 141 patients (49.6 %) achieved CR, with a median time to remission of 397 days. In multivariate Cox regression analyses, TSP had an impact on achieving CR in only the group with histological grade 3 defined as glomerulosclerosis, crescent formation or adhesion to Bowman’s capsule in 10–30 % of all biopsied glomeruli, or mild cellular infiltration in the interstitium (hazard ratio (HR) 4.29, 95 % confidence interval (95 %CI) 1.88–11.19, P |
| تدمد: | 1437-7799 1342-1751 |
| DOI: | 10.1007/s10157-015-1131-1 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8ad381800394dcbc0e2888a1d82b159e https://doi.org/10.1007/s10157-015-1131-1 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....8ad381800394dcbc0e2888a1d82b159e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14377799 13421751 |
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| DOI: | 10.1007/s10157-015-1131-1 |