Immunosuppression, tonsillectomy and remissions in high-risk IgA-nephropathy
- 作者: Kochoyan Z.1, Lieva A.1, Galkovskaya T.1, Dobronravov V.1
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隶属关系:
- Pavlov First Saint Petersburg State Medical University
- 期: 卷 96, 编号 6 (2024): Нефрология
- 页面: 600-605
- 栏目: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/260073
- DOI: https://doi.org/10.26442/00403660.2024.06.202728
- ID: 260073
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Aim.To evaluate the efficacy of immunosuppressive therapy (IST) and tonsillectomy (TE) in patients with high-risk IgA nephropathy (IgAN).
Materials and мethods. The retrospective study cohort included cases with primary IgAN (n=213, age 34±11 years, male 52%) at high risk of progression with clinical and morphological data collected. The follow-up was 26 (10; 61) months. The association of IST without TE (IST; n=141) or with TE (IST+TE; n=72) with the development of complete (PR), partial (PR) and overall (PR or PR, OR) remissions was investigated.
Results. The incidence of achieving early PR or OR in the IST and IST+TE groups was 65.2% and 86.1%, respectively (p=0.002). The probability of early PR or OR was significantly increased in the IST+TE group compared to IST [HR 1.714 (1.214–2.420) and HR 3.410 (1.309–8.880), respectively]. IST+TE was associated with a 3- to 4-fold increase in the likelihood of PR or OR at the end of follow-up [HR 2.575 (1.679–3.950) and HR 4.768 (2.434–9.337), respectively]. Analyses using pseudorandomisation methods yielded similar results.
Conclusion. TE may be effective for remission induction in high-risk IgAN.
作者简介
Zinaida Kochoyan
Pavlov First Saint Petersburg State Medical University
Email: dobronravov@nephrolog.ru
ORCID iD: 0000-0001-8433-876X
врач-нефролог нефрологического отд-ния №3 Научно-исследовательского института нефрологии
俄罗斯联邦, Saint PetersburgAlina Lieva
Pavlov First Saint Petersburg State Medical University
Email: dobronravov@nephrolog.ru
ORCID iD: 0009-0006-3800-1246
клин. ординатор каф. пропедевтики внутренних болезней
俄罗斯联邦, Saint PetersburgTatyana Galkovskaya
Pavlov First Saint Petersburg State Medical University
Email: dobronravov@nephrolog.ru
ORCID iD: 0009-0008-8851-8061
врач-нефролог нефрологического отд-ния №2 Научно-исследовательского института нефрологии
俄罗斯联邦, Saint PetersburgVladimir Dobronravov
Pavlov First Saint Petersburg State Medical University
编辑信件的主要联系方式.
Email: dobronravov@nephrolog.ru
ORCID iD: 0000-0002-7179-5520
д-р мед. наук, проф., дир. Научно-исследовательского института нефрологии
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