Evidence map›Paper›PMID 38954311›Full record

ArticleClinical and experimental nephrology2024

Effect of tonsillectomy combined with steroid pulse therapy upon IgA nephropathy depending on proteinuria status at diagnosis: a nationwide multicenter cohort study in Japan.

Hiroyuki Komatsu, Shouichi Fujimoto, Yuji Sato, Takashi Yasuda, Yoshinari Yasuda, Keiichi Matsuzaki, Keita Hirano, Tetsuya Kawamura, Takashi Yokoo, Yusuke Suzuki and 1 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and experimental nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hiroyuki KomatsuCenter for Medical Education and Career Development, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. hiroyuki_komatsu@med.miyazaki-u.ac.jp.
Shouichi FujimotoDepartment of Medical Environment Innovation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Yuji SatoDepartment of Internal Medicine, Division of Nephrology, National Health Insurance Takachiho Town Hospital, Takachiho, Miyazaki, Japan.
Takashi YasudaDepartment of Internal Medicine, Kichijoji Asahi Hospital, Tokyo, Japan.
Yoshinari YasudaDepartment of Nephrology/CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Keiichi MatsuzakiDepartment of Public Health, Kitasato University School of Medicine, Kanagawa, Japan.
Keita HiranoDivision of Nephrology, Department of Internal Medicine, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Tetsuya KawamuraDivision of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Takashi YokooDivision of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Yusuke SuzukiDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Shoichi MaruyamaDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Nagoya, Nagoya, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effects of tonsillectomy combined with steroid pulse (TSP) therapy for IgA nephropathy (IgAN) are little known. Therefore, we examined the effects of TSP therapy on the kidney outcomes of IgAN in a large, nationwide cohort study in Japan.

methodsBetween 2002 and 2004, 632 IgAN patients with ≥ 0.5 g/day proteinuria at diagnosis were divided into three groups with mild (0.50-0.99 g/day; n = 264), moderate (1.00-1.99 g/day, n = 216), or severe (≥ 2.00 g/day; n = 153). Decline in kidney function and urinary remission were compared among the three groups after TSP therapy, corticosteroid (ST) therapy, or conservative therapy during a mean follow-up of 6.2 ± 3.3 years. 10.6% and 5.9% of patients in the ST and conservative therapy group underwent tonsillectomy.

resultsThe rate of urinary remission at the final observation was significantly higher in the TSP therapy group than in the ST or conservative therapy groups (mild proteinuria: 64%, 43%, and 41%; moderate proteinuria: 51%, 45%, and 28%; severe proteinuria: 48%, 30%, and 22%, respectively). In contrast, the rate of a 50% increase in serum creatinine was lower in groups TSP therapy, than ST or conservative therapy (mild proteinuria: 2.1%, 10.1% and 16.7%; moderate proteinuria: 4.8%, 8.8% and 27.7%; severe proteinuria: 12.0%, 28.9% and 43.1%, respectively). In multivariate analysis, TSP therapy significantly prevented a 50% increase in serum creatinine levels compared with conservative therapy in groups with moderate and severe proteinuria (hazard ratio, 0.12 and 0.22, respectively).

conclusionTSP significantly increased the rate of proteinuria disappearance and urinary remission in IgAN patients with mild-to-moderate urinary protein levels. It may also reduce the decline in kidney function in patients with moderate-to-severe urinary protein levels.

Indexed as

Glomerulonephritis, IGAProteinuriaRemission InductionTonsillectomyAdultCombined Modality TherapyFemaleHumansJapanKidneyMaleMiddle AgedPulse Therapy, DrugRetrospective StudiesTreatment OutcomeYoung AdultGlomerulonephritisIgA nephropathyKidney outcomeProteinuriaSteroid pulse therapyTonsillectomy

Identifiers

PMID38954311
PMCPMC11621197

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.