title: Comparison of methods of steroid administration combined with tonsillectomy for IgA nephropathy patients.
abstract: BACKGROUND
  IgA nephropathy (IgAN) is a chronic glomerular disease that causes end-stage renal disease in 20-40 % of patients within 20 years. The efficacy of tonsillectomy combined with steroid pulse (SP) administration (TSP) for clinical remission of IgAN has been reported. Particularly in Japan, TSP has been performed widely. However, the optimum method for steroid administration in TSP has not been established.
  
  
  METHODS
  We retrospectively compared clinical remission in IgAN patients treated with tonsillectomy combined with two different steroid administration methods: (1) three courses of SP therapy and oral prednisolone administered on alternate days (group 3A; n = 25); and (2) one course of SP therapy and oral prednisolone administered on consecutive days (group 1C; n = 22).
  
  
  RESULTS
  There was no significant difference in the clinical remission rates between the two groups at 12 (48.0 vs. 40.9 %, P = 0.77) and 24 months after starting treatment (68.0 vs. 72.7 %, P = 0.76) and at the final observation (76.0 vs. 81.8 %, P = 0.73). The mean period from starting treatment to remission of hematuria in group 3A was significantly shorter than that in group 1C (5.7 ± 4.4 vs. 9.9 ± 5.9 months, P = 0.03). Dyslipidemic patients treated for the first time with statin after the SP therapy were more present in group 3A at 24 months (P = 0.02).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoku, Niigata, Niigata, 951-8510, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoku, Niigata, Niigata, 951-8510, Japan. gotos@med.niigata-u.ac.jp.
authors.forename: Shin
authors.initials: S
authors.lastname: Goto
authors.affiliation: Department of Nephrology and Rheumatology, Niigata City General Hospital, Niigata, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kondo
authors.affiliation: Department of Nephrology, Nagaoka Chuo General Hospital, Nagaoka, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Takata
authors.affiliation: Department of Internal Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Clinical Nutrition Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hosojima
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoku, Niigata, Niigata, 951-8510, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoku, Niigata, Niigata, 951-8510, Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Kaneko
authors.affiliation: Department of Nephrology, Tachikawa General Hospital, Nagaoka, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Aoyagi
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoku, Niigata, Niigata, 951-8510, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: IgA nephropathy; Steroid pulse therapy; Tonsillectomy; Treatment protocol