Comparison of methods of steroid administration combined with tonsillectomy for IgA nephropathy patients

Watanabe, Hirofumi; Goto, Shin; Kondo, Daisuke; Takata, Takuma; Yamazaki, Hajime; Hosojima, Michihiro; Yamamoto, Shuichi; Kaneko, Yoshikatsu; Aoyagi, Ryuji; Narita, Ichiei

doi:10.1007/s10157-016-1282-8

Cited by 7 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study indicated that the addition of mizoribine might reduce the required number of courses of corticosteroid pulse therapy. Watanabe et al [ 27 ] showed that TSP3 had an effect to rapidly induce remission of hematuria compared to TSP1, although there was no significant difference in the clinical remission rates between the 2 groups, which was consistent with our study. Their study was conducted over a short term and did not assess renal outcome.…”

Section: Discussionsupporting

confidence: 92%

Comparison of administration of single- and triple-course steroid pulse therapy combined with tonsillectomy for immunoglobulin A nephropathy

et al. 2021

View full text Add to dashboard Cite

Immunoglobulin A nephropathy (IgAN) is a form of chronic glomerulonephritis that can cause end-stage renal disease. Recently, tonsillectomy combined with corticosteroid pulse (TSP) has been shown to be effective for achieving clinical remission and favorable renal outcome in patients with IgAN. However, the standard regimen of corticosteroid use in TSP has not been established. Herein, we compared the effect of single- or triple-course steroid pulse therapy combined with tonsillectomy in patients with IgAN. This retrospective, observational cohort study included 122 patients with IgAN enrolled from January 2004 to December 2018 at 2 independent institutions. We divided the patients into 2 groups; single-course (TSP1: n = 70) and triple-course (TSP3: n = 52) of corticosteroid pulse therapy (1 course comprised 3 consecutive days’ infusion of 0.5 g methylprednisolone) combined with tonsillectomy. The primary outcome for renal survival was defined as the first occurrence of ≧30% decrease in estimated glomerular filtration rate from baseline. Secondary outcomes included the incidence of clinical remission and recurrence of the disease. Regarding clinical parameters and findings at baseline, there were no significant differences between the 2 groups. The 8-years renal survival in the 2 groups was not significantly different according to Kaplan–Meier curves (TSP1; 82.5% vs TSP3; 69.2%, log-rank test P = .39). The cumulative incidence rates of remission of hematuria (94.4% vs 85.4%, P = .56) and clinical remission (85.0% vs 64.8%, P = .07) were comparable in both groups, while those of proteinuria showed higher rates in TSP1 than TSP3 (88.4% vs 65.4%, P = .02). The cumulative incidence of relapse of hematuria (5.6% vs 2.3%, P = .42) and proteinuria (7.1% vs 3.3%, P = .41) showed no significant differences in the 2 groups. Cox regression analyses showed that the number of courses of corticosteroid pulse therapy was not significantly associated with renal outcome (TSP1 vs TSP3; Hazard ratios 0.69, 95% confidence intervals 0.29-1.64, P = .39). The effect of single-course corticosteroid pulse therapy is not statistically, significantly different from triple-course in TSP protocol for improving renal outcome and preventing relapse in patients with IgAN. Single-course corticosteroid pulse therapy may become a treatment option for patients with IgAN.

show abstract

Section: Discussionsupporting

confidence: 92%

Comparison of administration of single- and triple-course steroid pulse therapy combined with tonsillectomy for immunoglobulin A nephropathy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The prevalence of IgAN shows marked differences across different ethnic groups, being more prevalent in people with East Asian ancestry and less prevalent in people with African ancestry compared with Caucasians 2 . In addition, differences in the clinical features of IgAN in Caucasian compared with Chinese patients have been recognized for a long time 3 , most notably the clear male preponderance of IgAN in Caucasian studies of IgAN that is absent (or even reversed) in East Asian populations, suggesting that important and incompletely understood differences in disease pathophysiology exist across different populations [4][5][6][7][8] . Recent work has identified a number of genetic factors, mostly associated with mechanisms of defense against infection, that are associated with altered risk of disease [9][10][11] , and although the prevalence of the known genetic factors vary across different ethnic groups, the observed differences fall some way short of explaining the differences in prevalence of the disease in different regions 2,12 .…”

Section: Introductionmentioning

confidence: 99%

Galactosylation of IgA1 Is Associated with Common Variation in C1GALT1

Gale

Molyneux

Wimbury

et al. 2017

JASN

105

View full text Add to dashboard Cite

IgA nephropathy (IgAN), an important cause of kidney failure, is characterized by glomerular IgA deposition and is associated with changes in O-glycosylation of the IgA1 molecule. Here, we sought to identify genetic factors contributing to levels of galactose-deficient IgA1 (Gd-IgA1) in Caucasian and Chinese populations.Gd-IgA1 levels were elevated in IgAN patients compared with ethnically matched healthy subjects and correlated with evidence of disease progression. Caucasian IgAN patients exhibited significantly higher Gd-IgA1 levels than Chinese patients. Among individuals without IgAN, Gd-IgA1 levels were not correlated with kidney function. Gd-IgA1 level heritability (h ). This association was replicated in GWAS of separate cohorts comprising: 308 UK patients with membranous glomerulonephritis (p<10

show abstract

“…To date, no study has been reported on the comparison of the clinical course between the two SP protocols. However, there are several studies on the number of sessions of SP therapy, and three session of SP therapy were reported to have a higher remission rate of urinary findings than did one or two sessions of SP therapy [ 23 ]. Considering the nature of SP therapy, as the dose of steroids administered in the first month is high in the CSP group, earlier remission of proteinuria would be obtained in this group than in the ISP group.…”

Section: Discussionmentioning

confidence: 99%

“…When choosing SP therapy, the adverse effects and length of hospitalization should be considered. Since the adverse effects of steroid therapy have been shown in several previous reports, they have been recognized as profound issues [ 15 , 23 ]. As expected, these previous studies have reported that SP therapy led to the amelioration of urinary findings and slowing down the progression of kidney dysfunction; however, it also significantly increased the risk for adverse events [ 10 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of two protocols for steroid pulse therapy in patients with IgA nephropathy: a retrospective observational study

et al. 2022

View full text Add to dashboard Cite

Background Steroid pulse (SP) therapy is one of the immunosuppressive therapies for immunoglobulin A nephropathy (IgAN). Although there are various protocols of SP therapy in IgAN, the intermittent SP (ISP) and consecutive SP (CSP) protocols are prevalently performed in clinical settings. However, there is a lack of evidence of comparisons of the effects on IgAN between these two protocols. Methods A total of 189 patients with IgAN who had received SP therapy were included in this study. They were divided into two groups according to the SP protocols into the intermittent SP (ISP) or consecutive SP (CSP) group as follows: ISP; three-times SP therapy in alternate months, CSP; three-times SP therapy in three consecutive weeks. Kidney function, remission of urinary findings, and side effects of SP therapy were compared between the two groups. The observational period was 12 months after the initiation of SP therapy. Results There was no significant difference in kidney function between the two groups during the observational period. The remission rate of proteinuria and hematuria at 12 months also did not significantly differ between the two groups. Furthermore, even after the adjustment of clinical characteristics using propensity score matching, the remission rate of proteinuria and hematuria at 12 months was similar between the two groups. At 2 months, the remission rate of proteinuria was significantly higher in the CSP group than in the ISP group. There were no critical side effects in both groups. Conclusion The effects of SP therapy on IgAN were similar between the ISP and CSP group at 12 months although CSP therapy could remit proteinuria faster than ISP therapy.

show abstract

Comparison of methods of steroid administration combined with tonsillectomy for IgA nephropathy patients

Abstract: In IgAN patients, treatment of group 3A may be effective for inducing rapid remission of hematuria. Further studies are needed to establish an appropriate protocol for TSP.

Cited by 7 publications

References 32 publications

Comparison of administration of single- and triple-course steroid pulse therapy combined with tonsillectomy for immunoglobulin A nephropathy

Comparison of administration of single- and triple-course steroid pulse therapy combined with tonsillectomy for immunoglobulin A nephropathy

Galactosylation of IgA1 Is Associated with Common Variation in C1GALT1

Comparison of two protocols for steroid pulse therapy in patients with IgA nephropathy: a retrospective observational study

Contact Info

Product

Resources

About