ArticleClinical and experimental nephrology2016
Tonsillectomy reduces recurrence of IgA nephropathy in mesangial hypercellularity type categorized by the Oxford classification.
Article in Clinical and experimental nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Long-term efficacy of tonsillectomy as a treatment in patients with IgA nephropathy: a meta-analysis.International urology and nephrology · 2017Pooled it
- [Clinical effect of double filtration plasmapheresis combined with glucocorticoid and immunosuppressant in treatment of children with severe Henoch-Schönlein purpura nephritis].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2019Trial
- Long-term outcomes of initial tonsillectomy and steroid pulse therapy in children with IgA nephropathy and heavy proteinuria: a single-center retrospective study.Clinical and experimental nephrology · 2026Article
- Iptacopan in Patients With IgA Nephropathy From East Asia.Kidney international reports · 2026Article
- Ethnicity and IgA nephropathy: worldwide differences in epidemiology, timing of diagnosis, clinical manifestations, management and prognosis.Clinical kidney journal · 2023Review
- How to take advantage of easily available biomarkers in patients with IgA nephropathy: IgA and C3 in serum and kidney biopsies.Pediatric nephrology (Berlin, Germany) · 2023Review
- Mucosal Immune System Dysregulation in the Pathogenesis of IgA Nephropathy.Biomedicines · 2022Review
- The association of 5-year therapeutic responsiveness with long-term renal outcome in IgA nephropathy.Clinical and experimental nephrology · 2022Article
- Evaluation of appropriate treatment for IgA nephropathy with mild proteinuria and normal renal function.Clinical and experimental nephrology · 2021Article
- Impact of the number of steroid pulses in tonsillectomy combined with steroid pulse therapy: a nationwide retrospective study in Japan.Clinical and experimental nephrology · 2021Article
- Risk factor for persistent proteinuria in adulthood after clinical remission in Japanese children with immunoglobulin A nephropathy: impact of tonsillectomy combined with intravenous pulse methylprednisolone.Clinical and experimental nephrology · 2020Article
- Association Between Galactose-Deficient IgA1 Derived From the Tonsils and Recurrence of IgA Nephropathy in Patients Who Underwent Kidney Transplantation.Frontiers in immunology · 2020Article
- Association Between Tonsillectomy and Outcomes in Patients With Immunoglobulin A Nephropathy.JAMA network open · 2019Observational
- The Emerging Role of Complement Proteins as a Target for Therapy of IgA Nephropathy.Frontiers in immunology · 2019Review
- Initial treatment with pulse methylprednisolone followed by short-term prednisolone and tonsillectomy for childhood IgA nephropathy.Clinical and experimental nephrology · 2018Article
- Seasonal proteinuria changes in IgA nephropathy patients after proteinuria remission.PloS one · 2017Article
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15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with IgA nephropathy (IgAN), recurrence after steroid pulse therapy is associated with reduced renal survival. However, the predictors of recurrence have not yet been clarified.
methodsAll patients who received 6-month steroid pulse therapy from 2004 to 2010 in our four affiliated hospitals and achieved a reduction of proteinuria to <0.4 g/day 1 year after treatment were retrospectively evaluated. The primary outcome was proteinuria ≥1.0 g/day during follow-up or additional antiproteinuric therapy. Two histological classifications were evaluated, the Oxford Classification with a split system and Japanese histological grades (HGs) with a lumped system.
resultsDuring a median follow-up of 3.4 years, 27 (26.7 %) of the 101 patients showed recurrence. Multivariate analysis showed that HG was the only significant predictor of recurrence, with HG 2+3+4 vs HG 1 having a hazard ratio of 7.38 (95 % confidence interval 1.52-133). Furthermore, in patients with mesangial hypercellularity according to the Oxford Classification, cumulative rate of recurrence-free survival was greater in patients with steroid therapy plus tonsillectomy compared with those who received steroid therapy alone (Log-rank test, P = 0.022). However, this association was not observed in patients without mesangial hypercellularity.
conclusionsHG is a novel predictor of recurrence after steroid pulse therapy in patients with IgAN. Moreover, the combination of steroid pulse therapy plus tonsillectomy may indicate a lower risk of recurrence in patients with mesangial hypercellularity, as defined by the Oxford Classification.
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